title: Surgical correction of Madelung's deformity by combined corrective radioulnar osteotomy: 14 cases with four-year minimum follow-up.
abstract: Fourteen wrists in 11 girls, mean age 13.3 years (range 9-16) at surgery, were treated for Madelung's deformity. The presenting complaint was incapacitating pain. All were treated by radial closing wedge osteotomy and ulnar shortening osteotomy. The dorsal retinaculum was also surgically repaired in six cases. At a mean follow-up of 5.1 years (range 4-8.75), we observed improved range of motion in both flexion/extension and pronation/supination and absence of pain during daily activity. Radiographically, positioning of the distal radial articular surface and lunate subsidence were improved. Union was obtained after all osteotomies without secondary procedures. Posterior displacement of the ulnar head persisted in two wrists. Combined radioulnar osteotomy restored the anatomy to as near normal as possible. This technique provides satisfactory and encouraging results and does not compromise the surgical future of the wrist. However, longer follow-up is required to assess recurrence or possible long-term degenerative consequences.
authors.affiliation: Service de Chirurgie Orthopédique et de Traumatologie, Hôpital des Enfants, avenue de Grande Bretagne, Toulouse, France. jean-michel.laffosse@wanadoo.fr
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Laffosse
authors.forename: Abdelaziz
authors.initials: A
authors.lastname: Abid
authors.forename: Frank
authors.initials: F
authors.lastname: Accadbled
authors.forename: Gorka
authors.initials: G
authors.lastname: Knör
authors.forename: Jérôme
authors.initials: J
authors.lastname: Sales de Gauzy
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Cahuzac
mesh_terms: D000293:Adolescent; D018771:Arthralgia / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D001863:Bone Screws; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006227:Hand Deformities, Acquired / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D008069:Lipomatosis, Multiple Symmetrical / Q000150:complications*; D010027:Osteotomy / Q000295:instrumentation / Q000379:methods*; D011859:Radiography; D011884:Radius / Q000000981:diagnostic imaging / Q000601:surgery*; D016059:Range of Motion, Articular / Q000502:physiology; D016896:Treatment Outcome; D014457:Ulna / Q000000981:diagnostic imaging / Q000601:surgery*; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000601:surgery