Osteotomy of the radius and ulna for the Madelung deformity

Abstract

Correspondence should be sent to Mr M. V. Katchburian at 129 Old Dover Road, T he Madelung deformity can result in pain and decreased function of the wrist and hand. None of the surgical techniques available has been shown consistently to improve grip strength, range of movement or relieve pain. In this prospective study we have treated 18 patients with the Madelung deformity (25 wrists) by wedge subtraction osteotomy of the radius and shortening of the ulna. Our results show statistically significant improvement in grip strength and range of movement of the wrist and forearm. Pain improved in 80% of the patients and 88% were satisfied with the appearance. One patient had a wound infection and another developed reflex sympathetic dystrophy. Two had some recurrence due to continued growth of the ulna and it is recommended that the procedure be delayed until skeletal maturity, or else combined with epiphysiodesis of the ulna.

Surgical Management of Madelung Deformity: A Systematic Review

“…In addition, 8 studies assessed grip strength. 1,4,8,13,18,20,44,48 As part of the diagnostic process, 14 studies used their own radiographic criteria, 5 studies used the McCarroll criteria, 38 and 3 studies used the Dannenberg criteria. 14 The remaining 3 studies did not specify criteria used.…”

“…50 Because of its progressive nature, the deformity can lead to wrist pain, restricted range of motion (ROM), and loss of grip strength, heavily interfering with daily activities. 18,21,30 In addition, patients can complain about the visible deformity caused by prominence of the distal ulna. 30 Madelung deformity often occurs bilaterally, 46 is most often diagnosed in adolescent females, 40 and has been associated with genetic disorders such as Léri-Weill dyschondrosteosis (LWD) and Turner syndrome.…”

Quantitative three-dimensional assessment of Madelung deformity

“…Currently, most surgeons treat the deformity with osteotomies of the radius and/or ulna, the rationale being that restoring skeletal angles improves wrist biomechanics and function (dos Reis et al., 1998). Although postoperative outcomes seem satisfactory, some patients require revision surgery due to complications (Peymani et al., 2018).…”

Very Distal Radial Osteotomy For Madelung's Deformity

“…[9][10][11] Several researchers have called attention to the importance of preserving the distal radioulnar joint (DRUJ) during correction of Madelung's deformity. 7,8,[11][12][13][14] This important principle is incorporated in the technique described here, which allows individual correction of the 3 components of Madelung's deformity.…”