Madelung’s Deformity: Quantitative Assessment of X-Ray Deformity

McCarroll, H. Relton; James, Michelle A.; Newmeyer, William L.; Molitor, Fred; Manske, Paul R.

doi:10.1016/j.jhsa.2005.06.024

Cited by 62 publications

(72 citation statements)

References 26 publications

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“…7) [18,19]. Measurement of ulnar tilt, lunate subsidence and palmar carpal displacement may help to determine the severity of the deformity and advise surgical planning [20,21].…”

Section: Radiographic Featuresmentioning

confidence: 99%

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Madelung deformity and Madelung-type deformities: a review of the clinical and radiological characteristics

et al. 2015

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Madelung deformity of the distal radius results from premature closure of the medial volar aspect of the distal radial physis, leading to increased volar tilt and increased inclination of the radial articular surface, triangulation of the carpus with proximal migration of the lunate and dorsal displacement of the distal ulna. The deformity is particularly common in Leri-Weill dyschondrosteosis, but it may also occur in isolation. True Madelung deformity can be differentiated from Madelung-type deformities by the presence of an anomalous radiolunate ligament (Vickers ligament). In this article, we will review the imaging characteristics of true Madelung deformity, including the common "distal radius" variant, the less common "entire radius" variant and "reverse" Madelung deformity. We will discuss the role of the Vickers ligament in disease pathogenesis and its use in differentiating true Madelung deformity from Madelung-type deformities arising from trauma or multiple hereditary exostoses. Surgical management of these patients will also be addressed.

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“…7) [18,19]. Measurement of ulnar tilt, lunate subsidence and palmar carpal displacement may help to determine the severity of the deformity and advise surgical planning [20,21].…”

Section: Radiographic Featuresmentioning

confidence: 99%

“…Leri-Weill dyschondrosteosis is characterized by Madelung deformity, marked short stature (<25th percentile) and short forearms (mesomelia) (Fig. 1) [20,21]; all three features must be present for the diagnosis to be made. Several familial cases of isolated Madelung deformity have also been described [6,13].…”

Section: Associationsmentioning

confidence: 99%

Madelung deformity and Madelung-type deformities: a review of the clinical and radiological characteristics

et al. 2015

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“…If comparison of clinical data seems easy, the radiographic data are difficult to analyse. It would be preferable to use radiological criteria which are more reproducible [11,15], such as lunate subsidence, measurement of orientation of the distal radial articular surface in Salon et al [19] and Dos Reis et al [7] reported satisfactory clinical results after double distal radioulnar osteotomy in a series of 11 wrists with a mean follow-up of 9.7 years (range 1.5 -22) and in 18 adult patients with a mean follow-up of 4.45 years (range 1.8 -6.3), respectively. Pain during daily activities decreased significantly and joint mobility improved, with a satisfactory cosmetic appearance.…”

Section: Discussionmentioning

confidence: 99%

“…Forward tilt of the distal radial articular surface and volar displacement of the wrist were compared with the axis of the ulnar diaphysis on lateral radiographs (Fig. 6), and lunate subsidence was measured on anteroposterior radiographs as described by McCarroll et al [15] (Fig. 7).…”

Section: Methodsmentioning

confidence: 99%

“…The radial osteotomy was internally fixed with wires in eight wrists and with plates (lateral or posterior) in six. The ulnar shortening osteotomy was adjusted under intra-operative radiographic monitoring to restore satisfactory ulnar subsidence [15] and internal fixation was carried out using a compression plate. Mean ulnar shortening was 8.4 mm (range 5-10).…”

Section: Surgical Techniquementioning

confidence: 99%

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

Laffosse

Abid

Accadbled

et al. 2008

International Orthopaedics (SICOT)

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Fourteen wrists in 11 girls, mean age 13.3 years (range 9-16) at surgery, were treated for Madelung's deformity. The presenting complaint was incapacitating pain. All were treated by radial closing wedge osteotomy and ulnar shortening osteotomy. The dorsal retinaculum was also surgically repaired in six cases. At a mean followup of 5.1 years (range 4-8.75), we observed improved range of motion in both flexion/extension and pronation/ supination and absence of pain during daily activity. Radiographically, positioning of the distal radial articular surface and lunate subsidence were improved. Union was obtained after all osteotomies without secondary procedures. Posterior displacement of the ulnar head persisted in two wrists. Combined radioulnar osteotomy restored the anatomy to as near normal as possible. This technique provides satisfactory and encouraging results and does not compromise the surgical future of the wrist. However, longer follow-up is required to assess recurrence or possible long-term degenerative consequences.Resumé Quatorze poignets chez 11 filles d'âge moyen 13,3 ans (9-16) à la chirurgie, ont été traités pour une déformation de Madelung. La douleur était la plainte principale. Tous les patients ont bénéficié d'une ostéotomie cunéiforme radiale de fermeture associée à un raccourcissement de l'ulna. Une plastie du retinaculum dorsal a été associée dans 6 cas. Au recul moyen de 5,1 ans (4-8,75), nous avons observé une amélioration des amplitudes articulaires aussi bien en flexion/extension qu'en pronation/supination avec absence de douleur lors des activités quotidiennes. Radiographiquement, l'orientation de la glène radiale ainsi que la subsidence du lunatum ont été améliorées. Toutes les ostéotomies ont consolidé en première intention dans des délais normaux. Un déplace-ment postérieur de la tête ulnaire persistait dans 2 cas. L'ostéotomie combinée radio-ulnaire permet de restaurer une anatomie le plus proche de la normale. Cette technique offre des resultants satisfaisants et encourageants et ne compromet pas le devenir chirurgical de ces poignets. Cependant, des études avec un plus long recul sont nécessaires afin de rechercher d'éventuelles récidives ou de possibles conséquences dégénératives à plus long terme.

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Hand and Upper Extremity

Pirela-Cruz

2013

Pediatric Orthopedics

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Madelung’s Deformity: Quantitative Assessment of X-Ray Deformity

Cited by 62 publications

References 26 publications

Madelung deformity and Madelung-type deformities: a review of the clinical and radiological characteristics

Madelung deformity and Madelung-type deformities: a review of the clinical and radiological characteristics

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

Hand and Upper Extremity

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