Transfers of the sternal head of pectoralis major and latissimus dorsi to treat Sprengel’s syndrome

BackgroundThis technical note introduces a novel surgical procedure for the treatment of Sprengel's Syndrome, a rare congenital condition characterized by an elevated, hypoplastic, and malrotated scapula. Traditional treatments have had limited success, prompting the development of this new approach. The technique, grounded in orthopedic principles, combines muscle and bone repositioning to improve range of motion, reduce pain, and achieve aesthetic normalization.The surgery involves clavicle morcellation and a posterior longitudinal approach for muscle release and transfer. The patient is positioned laterally under general anesthesia, with evoked potential monitoring to prevent neurological complications. Clavicle morcellation is performed to facilitate scapula movement and prevent brachial plexus impingement. The procedure includes releasing fibrous bands and specific muscles around the scapula, with careful attention to avoid nerve damage. The innovative aspect lies in the transfer of the sternal head of the pectoralis major and the latissimus dorsi to the inferior aspect of the scapula, aiming to restore functional scapula movement. A case report of a 4 year old patient demonstrates the procedure's efficacy, highlighting improvements in scapular elevation and deltoid strength. Cosmetic enhancements are also noted. This approach potentially offers significant advantages for patients with Sprengel's Syndrome.ConclusionThe note concludes with a discussion on the rationale behind muscle transfers and their role in enhancing scapular movements, providing a promising outlook for this challenging congenital condition.