Correction of Madelung’s deformity by the Ilizarov technique

Abstract

We present our experience with correction of Madelung's deformity by the Ilizarov technique. Seven patients (eight deformities) were treated by osteotomy of the radius with subsequent lengthening and angular correction. They were reviewed at a mean of 30 months (1.5 to 5.5 years). At the time of operation their mean age was 19 years (9 to 44). At follow-up all were free from pain and supination had improved by a mean of 34 degrees and pronation by 9 degrees. Flexion had increased in most cases with a median increase of 15 degrees, but only one patient gained further extension. Radial and ulnar deviation were increased by a mean of 6 degrees and 9 degrees, respectively. Radiographic measurements showed that the mean volar angulation had been reduced from 25 degrees to 11 degrees, ulnar inclination from 45 degrees to 30 degrees and carpal malalignment (volar translation) from 7 to 2 mm. The mean lengthening of the radius was 12 mm (6 to 25). All the patients were satisfied with the functional and cosmetic results.

Radiographic Criteria for Undergoing an Ulnar Shortening Osteotomy in Madelung Deformity

“…2,5,9,[14][15][16][17][18] Surgical treatment is typically reserved for adolescents with pain, functional limitations, and/or progressive deformity failing nonoperative treatment and should be tailored to each affected wrist. Radius dome osteotomy is a useful procedure to reliably correct the increased radial tilt present in almost all cases.…”

Surgical correction of Madelung’s deformity by combined corrective radioulnar osteotomy: 14 cases with four-year minimum follow-up

“…These procedures belong in general to three broad groups: first, surgery to correct the radius (epiphysiodesis, desepiphysiodesis, corrective osteotomy [5,6,13,14] or progressive lengthening [12]); second, surgery to correct the ulna (ulna reduction osteotomy [3,18], resection-stabilisation of the ulnar head using a Darrach procedure [6,18], radioulnar arthrodesis using the Sauvé-Kapandji procedure [2,6]); and third, the combined techniques comprising surgery on both radius and ulna [6,7,13,18,19,23]. There are too few consistent series with sufficient follow-up in the literature to allow assessment of the results of these techniques [3,7,16,18,19].…”

Deformity correction with the Taylor spatial frame after growth arrest of the distal radius: A technical note on 2 cases

“…Furthermore, it is difficult to control the proper amount of correction intraoperatively. Gradual corrections using callus distraction with external unilateral or Ilizarov ring fixators have been used more frequently in severe forearm shortening, especially in children with Madelung deformities (Villa et al 1990, Bader and Grill 2000, Houshian et al 2004, Hosny 2005, Matsuno et al 2006. The gradual correction of deformities allows soft tissue to adapt slowly to the lengthened bone.…”