Presentation
Female patient with deformity of both forearms with restricted mobility.
Patient Data
Radiographs typically show a short, curved radius with a greater volar inclination of its distal segment, which determines a widening of the distal radius-ulnar joint. There is also an exaggerated ulnar inclination of the articular surface of the distal radius, with dorsal subluxation of the ulna and triangular deformity of the carpus. The carpal bones form a wedge in the triangular deformity created by the distal radius, with the lunate at the apex.
Case Discussion
Madelung's deformity is defined as a marked bowing of the radial shaft associated with increased interosseous space and dorsal distal radioulnar joint subluxation.
It is due to an early closure or defect of the ulnar third of the radial physis.
In 50-60% of cases, it can be bilateral. It is associated with rare congenital deformities such as Turner's syndrome, gonadal dysgenesis, achondroplasia, Ollier's disease, and Leri-Weill dyschondrosteosis.
Surgical options include:
- radial epiphysiodesis
- radial corrective osteotomy
- radial physiolysis
- ulnar epiphysiodesis
- distal ulnar excision
- ulnar shortening osteotomy