Case 2
Diagnosis
Madelung deformity
Ghatan AC1, Hanel DP. Madelung deformity. J Am Acad Orthop Surg. 2013;21(6):372-82.
- Partial closure of the ulnar and volar side of the distal radial growth plate. This leads to shortening and deformity of the radius (dorsal and radial bowing) and relative overgrowth of the ulna.
- Bilateral in 50-66%. More common in females.
- Usually congenital deformity less common traumatic origin.
- Vickers ligament is a fibrous band running from the distal radius to the lunate on the volar surface of the wrist a pathologically thick radiolunotriquetral ligament
- Presentation with deformity, decreased grip strength and often with pain in the wrist relating to ulnocarpal impaction.
- Radiographic features: characteristic undergrowth of the volar, ulnar corder of the radius, increased radial inclination, increased volar tilt, carpal subluxation in a palmar and ulnar direction lunate is gradually forced to the apex of the V-shaped positive ulnar variance wedging of the carpus between the radius and ulna
- Treatment: Vascularized osteochondral autograft (base of the second metatarsal).
Ghatan AC1, Hanel DP. Madelung deformity. J Am Acad Orthop Surg. 2013;21(6):372-82.
