eMedicine Specialties > Orthopedic Surgery > Pediatrics

Madelung Deformity: Follow-up

Author: Paul M Lamberti, MD, Principal Surgeon, Lamberti Orthopedic and Hand Surgery, LLC
Coauthor(s): Terry R Light, MD, Dr Wm M Scholl Professor and Chair, Department of Orthopedic Surgery, Loyola University School of Medicine; Consulting Surgeon, Department of Orthopedic Surgery and Rehabilitation, Loyola University Medical Center
Contributor Information and Disclosures

Updated: Mar 4, 2008

Outcome and Prognosis

Goals for surgical correction of MD consist primarily of pain relief and correction of the cosmetic deformity. A secondary goal is to increase range of motion. Most patients who undergo biplane osteotomy with ulnar length adjustment or the crescentic radial osteotomy of Carter and Ezaki19 attain both primary goals. Range of motion usually is only moderately improved at best. It should be noted that pain relief can be substantial and can be achieved quickly following release of the volar Vickers ligament.

Future and Controversies

Genetic links of MD to the SHOX gene on the X chromosome are emerging. No simple Mendelian inheritance pattern exists, so more than one gene most likely is involved. The interaction of the SHOX locus with other genes and transcription factors is not known and will be an area of future research. Results may provide a more complete answer to the link between dyschondrosteosis and MD.

Historically, surgical treatment of MD has been a closing wedge biplane osteotomy in conjunction with an ulnar shortening osteotomy of the distal ulna. Recently, a new procedure that addresses the deformity with a dome-shaped osteotomy, a release of Vickers ligament, and a reduction of the DRUJ without an ulnar procedure has been successfully used. This procedure shows great promise.

 


More on Madelung Deformity

Overview: Madelung Deformity
Workup: Madelung Deformity
Treatment: Madelung Deformity
Follow-up: Madelung Deformity
Multimedia: Madelung Deformity
References
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References

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Further Reading

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Keywords

progressive subluxation of the wrist, idiopathic curvature of the radius, MD, wrist pain, wrist deformity, spontaneous forward subluxation of the hand, Leri-Weill dyschondrosteosis, multiple hereditary osteochondromatosis, Ollier disease, achondroplasia, multiple epiphysial dysplasia, mucopolysaccharidoses, mucopolysaccharidosis, Hurler syndrome, Morquio syndrome

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Contributor Information and Disclosures

Author

Paul M Lamberti, MD, Principal Surgeon, Lamberti Orthopedic and Hand Surgery, LLC
Paul M Lamberti, MD is a member of the following medical societies: American Medical Association and American Society for Surgery of the Hand
Disclosure: Nothing to disclose.

Coauthor(s)

Terry R Light, MD, Dr Wm M Scholl Professor and Chair, Department of Orthopedic Surgery, Loyola University School of Medicine; Consulting Surgeon, Department of Orthopedic Surgery and Rehabilitation, Loyola University Medical Center
Terry R Light, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association for Hand Surgery, American College of Surgeons, American Orthopaedic Association, American Society for Surgery of the Hand, Association of Bone and Joint Surgeons, and Illinois Association of Orthopaedic Surgeons
Disclosure: Nothing to disclose.

Medical Editor

Charles T Mehlman, DO, MPH, Director, Musculoskeletal Outcomes Research, Associate Professor, Division of Pediatric Orthopedic Surgery, Cincinnati Children's Hospital Medical Center
Charles T Mehlman, DO, MPH is a member of the following medical societies: American Academy of Pediatrics, American Fracture Association, American Medical Association, American Orthopaedic Foot and Ankle Society, American Osteopathic Association, Arthroscopy Association of North America, North American Spine Society, Ohio State Medical Association, Pediatric Orthopaedic Society of North America, and Scoliosis Research Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

George H Thompson, MD, Director, Pediatric Orthopedics, Rainbow Babies and Children's Hospital
George H Thompson, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Association, Pediatric Orthopaedic Society of North America, and Scoliosis Research Society
Disclosure: Nothing to disclose.

CME Editor

Dinesh Patel, MD, FACS, Associate Clinical Professor of Orthopedic Surgery, Harvard Medical School; Chief of Arthroscopic Surgery, Department of Orthopedic Surgery, Massachusetts General Hospital
Dinesh Patel, MD, FACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association of Physicians of Indian Origin, American College of International Physicians, and American College of Surgeons
Disclosure: Nothing to disclose.

Chief Editor

Dennis P Grogan, MD, Clinical Professor, Department of Orthopedic Surgery, University of South Florida College of Medicine; Chief of Staff, Department of Orthopedic Surgery, Shriners Hospital for Children of Tampa
Dennis P Grogan, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Medical Association, American Orthopaedic Association, American Orthopaedic Foot and Ankle Society, Eastern Orthopaedic Association, Irish American Orthopaedic Society, Pediatric Orthopaedic Society of North America, and Scoliosis Research Society
Disclosure: Nothing to disclose.

 
 
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