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DOUBLE OSTEOTOMY OF THE RADIUS & ULNA FOR THE CORRECTION OF MADELUNG’S DEFORMITY: A NEW SURGICAL TECHNIQUE



Abstract

Introduction and Aims: The purpose of our study was to assess the efficacy of double osteotomy of the radius and ulna for correction of Madelung’s deformity. Made-lung’s deformity is a congenital alteration of the growth of the ulnar portion of the distal radius resulting in pain, decreased function of the wrist and hand and serious aesthetic disturbances.

Method: Four wrists in four patients with a mean age of 18.3 years were treated for symptomatic increased ulnar and volar inclination of the distal articular surface of the radius. All patients complained of wrist pain. In addition, two of them were dissatisfied with the aesthetic appearance of their wrist and the restricted range of movement. A double osteotomy of the radius and ulna was performed. The ulna was stabilised with a six-hole semi-tubular plate and the radius with a titanium T-plate.

Results: At one-year follow-up: pain relief and cosmetic appearance were satisfactory in all patients. Grip strength improved by 5.3 pounds. Average flexion improved from 63 to 67 degrees and pronation from 59 to 66 degrees. Abduction increased from three to six degrees and adduction from 16 to 21 degrees. Realignment of the wrist was shown radiographically by a change of ulnar inclination and volar inclination of the radius from 35.5 to 24 degrees and 15.5 to 10.5 degrees respectively. There was no evidence of recurrence of the deformity in any of the four wrists.

Conclusion: The initial results with the double osteotomy of the radius and ulna for Madelung’s deformity are promising but need longer follow-up.

These abstracts were prepared by Editorial Secretary, George Sikorski. Correspondence should be addressed to Australian Orthopaedic Association, Ground Floor, The William Bland Centre, 229 Macquarie Street, Sydney, NSW 2000, Australia.

At least one of the authors is receiving or has received material benefits or support from a commercial source.