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Modified Woodward’s Procedure in the Management of Neglected Sprengel’s Shoulder

Volume 8 | Issue 2 | May-August 2022 | Page: 02-05 | Tushar Nayak, Amrut Raje, Ashish Ragase, Love Kapoor , Venkatesan Sampath Kumar, Shah Alam Khan DOI- https://doi.org/10.13107/ijpo.2022.v08i02.136 Authors: Tushar Nayak MS Ortho [1], Amrut Raje MS Ortho [2], Ashish Ragase MS Ortho [2], Love Kapoor MS Ortho [3], Venkatesan Sampath Kumar MS Ortho [1], […]

Percutaneous Retrograde Extraphyseal screw fixation for Type II and III Anterior Tibial Spine Avulsion Fractures: A Technical Note

Volume 8 | Issue 2 | May-August 2022 | Page: 16-19 | R M Chandak, Mohit Sharma, Amit Nemade DOI- https://doi.org/10.13107/ijpo.2022.v08i02.140 Authors: R M Chandak [1], Mohit Sharma [1], Amit Nemade [2] [1] Department of Orthopedics & Trauma, Chandak Nursing Home, Nagpur, Maharashtra, India. [2] Department of Orthopedics, Kids Orth Clinic, Nagpur, Maharashtra, India. Address of […]

Modified Woodward’s Procedure in the Management of Neglected Sprengel’s Shoulder

Percutaneous Retrograde Extraphyseal screw fixation for Type II and III Anterior Tibial Spine Avulsion Fractures: A Technical Note

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Modified Woodward’s Procedure in the Management of Neglected Sprengel’s Shoulder

Volume 8 | Issue 2 | May-August 2022 | Page: 02-05 | Tushar Nayak, Amrut Raje, Ashish Ragase, Love Kapoor , Venkatesan Sampath Kumar, Shah Alam Khan

DOI- https://doi.org/10.13107/ijpo.2022.v08i02.136

Authors: Tushar Nayak MS Ortho [1], Amrut Raje MS Ortho [2], Ashish Ragase MS Ortho [2], Love Kapoor MS Ortho [3], Venkatesan Sampath Kumar MS Ortho [1], Shah Alam Khan MS Ortho [1]

[1] Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.
[2][ Department of Musculoskeletal Oncology, All India Institute of Medical Sciences, New Delhi, India.
[3] Department of Orthopaedics, N.C.I.; A.I.I.M.S, Jhajjar, Haryana, India.

Address of Correspondence
Dr. Tushar Nayak,
Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.
E-mail: orthodrtushar@gmail.com

Abstract

Introduction: With a less than ideal health infrastructure and a vast underprivileged population in our country, many cases of Sprengel’s deformity are initially missed and are subsequently untreated. Although for best surgical results, the patient must be under the age of five, many patients present late at out tertiary care center. Thus, we evaluated the clinical results of the modified Woodward’s Procedure in such neglected cases.
Methods: A retrospective study, of 16 patients aged 8-yr or above, with Sprengel’s deformity who underwent the modified Woodward’s procedure between 2006 and 2011. Clavicular osteotomy/morselization was avoided. The Cavendish scoring system was used to grade cosmesis and shoulder abduction was used to assess the functional outcome. The patients were prospectively followed up at two-years and after skeletal maturity.
Results: There were ten females and six males and the average age was 9.4 years. The mean follow up was 4.2 yr. Omo- vertebral bar excision was done in 13 (81.25%) patients. The mean increase in postoperative shoulder abduction and Cavendish grades at a 2-yr follow-up were, 19.1° and 1.32 grades, respectively. None of our patients needed Clavicular osteotomy/morselisation and none developed neurological abnormalities. The was no change in the values at skeletal maturity.
Conclusion: Satisfactory outcomes can be acquired by the Modified Woodward’s procedure in neglected Sprengel’s deformities. Besides a definitive cosmetic correction, the procedure also results in improvement of shoulder abduction. Clavicular Ostetomy/Morselization is not always required in cases presenting after the age of 8 years.
Keywords: Woodward’s procedure; Sprengel’s shoulder, Cavendish grading, modified Woodward’s procedure; neglected Sprengel deformity.

References

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How to Cite this Article: Nayak T, Raje A, Ragase A, Kapoor L, Kumar VS, Khan SA | Modified Woodward’s Procedure in the Management of Neglected Sprengel’s Shoulder | International Journal of Paediatric Orthopaedics | May-August 2022; 8(2): 02-05. https://doi.org/10.13107/ijpo.2022.v08i02.136

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Percutaneous Retrograde Extraphyseal screw fixation for Type II and III Anterior Tibial Spine Avulsion Fractures: A Technical Note

Volume 8 | Issue 2 | May-August 2022 | Page: 16-19 | R M Chandak, Mohit Sharma, Amit Nemade

DOI- https://doi.org/10.13107/ijpo.2022.v08i02.140

Authors: R M Chandak [1], Mohit Sharma [1], Amit Nemade [2]

[1] Department of Orthopedics & Trauma, Chandak Nursing Home, Nagpur, Maharashtra, India.
[2] Department of Orthopedics, Kids Orth Clinic, Nagpur, Maharashtra, India.

Address of Correspondence
Dr. Amit Nemade,
Consultant Pediatric Orthopedic Surgeon, Kids Orth Clinic, Nagpur, Maharashtra, India.
E-mail: kidsorth@gmail.com

Abstract

Introduction: Anterior tibial spine avulsion (ATSA) fractures are uncommon intra-articular knee injuries in children. They are common in adolescents. Treatment for displaced ATSA fracture is fixation. Various methods of fixation are documented, most common being arthroscopic assisted fixation using various sutures or anchors. Antegrade screw fixation is also an accepted method of treatment but is associated with implant back out and impingement. We describe our technique of retrograde extraphyseal percutaneous fixation for type II and III ATSA fractures.
Method: Under image intensifier (IITV) guidance, fracture reduction was achieved and fixed with a specially designed, short-threaded, 4mm cannulated screw. The screw was inserted in retrograde fashion proximal to the proximal tibial physis. The patient was immobilized in a cylinder cast and was allowed weight bearing as tolerated. Cast was removed at 6 weeks and range of movement exercises started.
Result: Our technique of percutaneous retrograde extraphyseal screw fixation for ATSA fracture is simple. The learning curve is less and can be used in selected case. In resource-limited situations where facilities for arthroscopy are not readily available, our technique can provide good results
Keywords: Anterior tibial spine avulsion, Percutaneous fixation, Retrograde, extraphyseal.

References

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[10] Herman MJ, Martinek MA, Abzug JM. Complications of tibial eminence and diaphyseal fractures in children: prevention and treatment. Instr Course Lect. 2015;64:471–82.
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[12] Xu X, Liu Z, Wen H, Pan X. Arthroscopic fixation of pediatric tibial eminence fractures using suture anchors: a mid-term follow-up. Arch Orthop Trauma Surg. 2017;137(10):1409–16.
[13] Xu P, Liu LC, Chen QJ, Yang P, Chen X Bin, Xie XP. The clinical effect and safety of the treatment of tibia intercondylar eminence fracture with cannulated screw and suture fixation under arthroscope: Protocol for a systematic review and meta-analysis of randomized controlled trials. Med (United States). 2020;99(23).
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How to Cite this Article: Chandak RM, Sharma M, Nemade A | Percutaneous Retrograde Extraphyseal screw fixation for Type II and III Anterior Tibial Spine Avulsion Fractures: A Technical Note | International Journal of Paediatric Orthopaedics | May-August 2022; 8(2): 16-19. https://doi.org/10.13107/ijpo.2022.v08i02.140

Half Sized Blog Element (Single Author Style)

Half Sized Blog Element (Multi Author Style)

Modified Woodward’s Procedure in the Management of Neglected Sprengel’s Shoulder

Percutaneous Retrograde Extraphyseal screw fixation for Type II and III Anterior Tibial Spine Avulsion Fractures: A Technical Note

Modified Woodward’s Procedure in the Management of Neglected Sprengel’s Shoulder

Percutaneous Retrograde Extraphyseal screw fixation for Type II and III Anterior Tibial Spine Avulsion Fractures: A Technical Note

Full Sized Blog Element (Big Preview Pic)

Modified Woodward’s Procedure in the Management of Neglected Sprengel’s Shoulder

Authors: Tushar Nayak MS Ortho [1], Amrut Raje MS Ortho [2], Ashish Ragase MS Ortho [2], Love Kapoor MS Ortho [3], Venkatesan Sampath Kumar MS Ortho [1], Shah Alam Khan MS Ortho [1]

Abstract

(Article Text HTML) (Full Text PDF)

Percutaneous Retrograde Extraphyseal screw fixation for Type II and III Anterior Tibial Spine Avulsion Fractures: A Technical Note

Authors: R M Chandak [1], Mohit Sharma [1], Amit Nemade [2]

Abstract

(Article Text HTML) (Full Text PDF)

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