Madelung Deformity

The Journal of Hand Surgery
Scott Kozin, Dan A Zlotolow

Abstract

Madelung deformity of the wrist is more common in females and is often associated with Leri Weill dyschondrosteosis, a mesomelic form of dwarfism. Patients with Madelung deformity often report wrist deformity resulting from the prominence of the relatively long ulna. The typical Madelung deformity is associated with a Vickers ligament that creates a tether across the volar-ulnar radial physis that restricts growth across this segment. The distal radius deforms in the coronal (increasing radial inclination) and the sagittal (increasing volar tilt) planes. There is lunate subsidence and the proximal carpal row adapts to the deformity by forming an upside-down pyramid shape or triangle. Treatment depends on the age at presentation, degree of deformity, and magnitude of symptoms. Mild asymptomatic deformity warrants a period of nonsurgical management with serial x-ray examinations because the natural history is unpredictable. Many patients never require surgical intervention. Progressive deformity in the young child with considerable growth potential remaining requires release of Vickers ligament and radial physiolysis to prevent ongoing deterioration Concomitant ulnar epiphysiodesis may be necessary. Advanced asymptomatic deformit...Continue Reading

References

Jan 1, 1977·Acta Orthopaedica Scandinavica·J B Nielsen
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Sep 3, 2013·The Journal of Hand Surgery·Yuko ImaiHisao Moritomo

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Citations

Jun 15, 2016·Der Orthopäde·F UnglaubC K Spies
Jun 17, 2016·Pediatric Radiology·Matthew J Winfeld, Hansel Otero
Mar 21, 2018·Pediatric Radiology·Ezekiel MaloneyMahesh M Thapa
Aug 14, 2018·Hand : Official Journal of the American Association for Hand Surgery·Abbas PeymaniSimon D Strackee
Oct 21, 2018·Skeletal Radiology·Theodore J HansonMark S Collins
Jan 19, 2021·The Journal of Hand Surgery, European Volume·Sebastian FarrDan A Zlotolow
Aug 5, 2019·International Journal of Paleopathology·Katie M Whitmore, Michele R Buzon
Apr 15, 2021·The Journal of Hand Surgery·Abbas PeymaniSimon D Strackee
Dec 12, 2018·Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons·Arnaud DepeyreJoël Ferri
Apr 13, 2021·Orthopaedics & Traumatology, Surgery & Research : OTSR·Marie BenayounFranck Fitoussi
Jun 8, 2021·Hand : Official Journal of the American Association for Hand Surgery·Annelinde R PiekSimon D Strackee
Jun 10, 2021·Journal of Plastic Surgery and Hand Surgery·Andrea Leti AcciaroRoberto Adani
Aug 13, 2021·Journal of Wrist Surgery·Richard SamadeKanu S Goyal
Nov 14, 2021·Hand : Official Journal of the American Association for Hand Surgery·Abbas PeymaniSimon D Strackee

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