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Madelung Deformity
Scott H Kozin1, Dan A Zlotolow2
1Department of Orthopaedic Surgery, Temple University, Philadelphia, PA; Shriners Hospitals for Children, Philadelphia, PA.
The Journal of Hand Surgery
|September 6, 2015
Summary
Madelung deformity, a wrist condition more common in females, involves radial bone growth restriction. Treatment ranges from observation for mild cases to surgical correction like dome osteotomy for progressive or symptomatic deformities.
Area of Science:
- Orthopedics
- Genetics
- Pediatric Orthopedics
Background:
- Madelung deformity is a wrist condition more prevalent in females.
- It is frequently linked to Leri-Weill dyschondrosteosis, a mesomelic dwarfism.
- The deformity results from a Vickers ligament tethering the volar-ulnar radial physis, impeding growth.
Purpose of the Study:
- To summarize the understanding of Madelung deformity.
- To outline current treatment strategies based on patient age, deformity severity, and symptoms.
Main Methods:
- Review of the pathophysiology of Madelung deformity.
- Discussion of treatment options, including non-surgical management and surgical interventions.
- Highlighting dome osteotomy as a corrective surgical technique.
Main Results:
- The distal radius deforms with increased radial inclination and volar tilt.
- Lunate subsidence occurs, and the carpal row adopts an inverted pyramid shape.
- Non-surgical management is suitable for mild, asymptomatic cases; surgery is indicated for progressive or symptomatic deformities.
Conclusions:
- Treatment for Madelung deformity is individualized based on clinical presentation.
- Early intervention with ligament release and physiolysis may be necessary for young children.
- Dome osteotomy offers a viable surgical solution for correcting advanced or symptomatic Madelung deformity.
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