Congenital Differences-Madelung Deformity

Madelung Deformity

Pdf Summary

Madelung deformity of the wrist is a condition that is more common in females and is often associated with Leri Weill dyschondrosteosis, a form of dwarﬁsm. Patients with Madelung deformity experience wrist deformity due to the prominence of the ulna. The deformity is caused by a Vickers ligament that creates a tether across the volar-ulnar radial physis, restricting growth. The distal radius deforms in the coronal and sagittal planes. Treatment options depend on the age, degree of deformity, and symptoms. Mild deformities that are asymptomatic may not require surgery, and nonsurgical management is recommended. Progressive deformities in children often require release of the Vickers ligament and radial physiolysis, and ulnar epiphysiodesis may be necessary. Advanced asymptomatic deformities in older children with an unacceptable appearance or symptomatic deformities are indications for surgery. A dome osteotomy of the radius allows for a 3-dimensional correction of the deformity. The procedure has shown positive results in terms of radiographic and clinical outcomes. Complications of the surgical procedures include incomplete physiolysis, improper placement of the osteotomy, and residual ulnar impaction. The outcome of treatment for Madelung deformity varies depending on the severity of the deformity. Physiolysis and ligament release have shown success in providing pain relief and improving radiographic findings, while dome osteotomy with ligament release has resulted in reduced pain, improved appearance, and maintained motion.

Keywords

Madelung deformity

wrist deformity

ulna prominence

Vickers ligament

dwarfism

treatment options

radial physiolysis

dome osteotomy

radiographic outcomes

surgical complications