Surgical correction of Madelung’s deformity by combined corrective radioulnar osteotomy: 14 cases with four-year minimum follow-up |
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Authors: | Jean-Michel Laffosse Abdelaziz Abid Frank Accadbled Gorka Knör Jérôme Sales de Gauzy Jean-Philippe Cahuzac |
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Institution: | 1.Service de Chirurgie Orthopédique et de Traumatologie, Hôpital des Enfants, avenue de Grande Bretagne, Toulouse, France ;2.Service de Chirurgie Orthopédique et Traumatologique, CHU de Rangueil, 1 avenue Jean Poulhès, TSA 50032, 31059 Toulouse Cedex 9, France |
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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. |
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