Woodward Scapula Depression

Woodward scapula scapula is used for the surgical treatment of congenital high shoulder scapula. Congenital high shoulder deformity (Sprengel malformation) refers to the normal position of the scapula corresponding to the thoracic bone, usually accompanied by scapular dysplasia and morphological abnormalities, and other parts of the deformity such as cervical ribs, cervical deformity and so on. About 1/3 of the sick children can be found that the shoulder vertebrae is a diamond-shaped bone or cartilage piece connecting the superior scapula and the adjacent spinous lamina spines. If the deformity is not serious and the shoulder joint dysfunction is also mild, surgery is not considered. On the contrary, different surgical methods must be chosen according to the age of the sick child and the degree of malformation in other parts. After the age of 3 is the best surgery period, as the age of the sick child increases, it will increase the difficulty of surgery. There are a variety of surgical procedures to correct this deformity. This section only describes the most common surgical procedures. Treatment of diseases: congenital high shoulder scapular congenital high shoulder scapula Indication Woodward Scapula Downward is suitable for: 1. Congenital high shoulder scapula, whose scapula is more than 2cm higher than the contralateral side and less than 120° shoulder abduction. 2. Age between 3 and 7 years old, able to tolerate the operator. With Green shoulder blade down. But this surgery is better. Many physicians praise this surgery and are listed as the first choice. Contraindications Sick children with obvious scapular scapula and those over 8 years old should not be treated. Otherwise, not only the surgical effect is not good, but also the traction brachial plexus injury may occur. Preoperative preparation Routine X-ray film, to understand the extent of the scapula elevation, whether there are shoulder vertebrae and their location, and whether there are congenital cervical deformity and cervical rib deformity. Surgical procedure Incision A median straight incision was made along the spinous process from the first cervical vertebra to the ninth thoracic vertebra. 2. Exposing and separating the scapular muscles The skin is removed to the outside, the subcutaneous tissue is transferred to the medial edge of the scapula, and the outer edge of the trapezius muscle is identified at the distal end of the incision, and the muscle and the deep latissimus dorsi muscle are bluntly separated. From the fascia of the sharp trapezius of the spine, the origin of the rhomboid muscle can be confirmed and sharply separated from the spinous process. Subsequently, the muscle is separated from the deep muscle of the chest wall together with the upper part of the trapezius muscle and retracted to the outside. At this point, the shoulder vertebrae or fiber band attached to the upper corner of the scapula can be fully revealed. 3. Excision of shoulder vertebrae and fiber bundles Once a shoulder vertebra is found, an extra-periosteal resection should be performed and a fiber band between the superior scapula and the spinous process should be examined. If there is a fiber band, it should be completely cut off, and the contracted shoulder muscles of the contracture should be cut off. If the upper part of the scapula is deformed, it can be removed together with the periosteum. Be careful not to damage the accessory nerve and the nerves and the transverse carotid artery that innervate the rhomboid muscle. 4. Move the shoulder blade down In the fourth cervical vertebra plane, the stenosis of the trapezius muscle is cut transversely. At this point, the shoulder blade can be pushed down, and the shoulder can be moved down to the same plane as the opposite shoulder. After stabilizing the scapula, the aponeurosis of the trapezius and the rhomboid muscle is sutured to the spinous process below the original starting point. The remainder of the distal portion of the trapezius muscle can be resected or overlapped. 5. Suture incision Thoroughly stop bleeding, suture the incision layeredly, and place rubber drainage, local compression dressing.

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