Glard Yann, Gay André, Launay Franck, Guinard Didier, Legré Régis
Department of Plastic and Reconstructive Surgery, Hôpital de la Conception, Marseille, France.
J Hand Surg Am. 2007 Sep;32(7):1037-42. doi: 10.1016/j.jhsa.2007.05.015.
Madelung's deformity is a characteristic pattern of anterior-ulnar bowing of the radius and a dorsally prominent ulnar head. Even if this deformity is associated with a certain degree of functional impairment, patients are satisfied with their function and mainly complain about the appearance of their wrists. The purpose of this study was to report a new surgical procedure (shortening combined with a slight anterior angulation osteotomy of the ulna) aiming to improve the appearance of the wrist and to relieve pain if present without compromising the function of the wrist. This technique is suitable for mild cases of Madelung's deformity.
This is a retrospective study of 4 wrists in 3 patients. All patients had a mild form of Madelung's deformity (without any dislocation of the lunate). Even if it was not their primary motivation to have surgery, all of the patients preoperatively experienced some wrist pain. An anterior angulation and shortening osteotomy of the ulna shaft was performed through a dorsal medial approach and fixed with a dynamic compression plate.
At 24 months follow-up, all of the patients were satisfied with the appearance of their wrists and forearms. The distal radioulnar joint was congruent radiologically in all cases, and the range of active pain-free forearm rotation improved.
This technique seems to be safe and reliable in mild cases of Madelung's deformity.
马德隆畸形是桡骨尺侧前方弓形弯曲及尺骨头背侧突出的一种特征性表现。即便这种畸形伴有一定程度的功能障碍，但患者对其功能仍感满意，主要抱怨的是手腕外观问题。本研究的目的是报告一种新的手术方法（尺骨缩短联合轻度前倾截骨术），旨在改善手腕外观，并在不影响手腕功能的前提下缓解疼痛（若存在疼痛的话）。该技术适用于轻度马德隆畸形病例。
这是一项对3例患者的4只手腕进行的回顾性研究。所有患者均为轻度马德隆畸形（月骨无脱位）。即便手术并非他们的主要诉求，但所有患者术前均经历过一些手腕疼痛。通过背内侧入路对尺骨干进行前倾和缩短截骨术，并用动力加压钢板固定。
随访24个月时，所有患者对手腕和前臂外观均感满意。所有病例影像学检查显示下尺桡关节均一致，且无痛性前臂主动旋转范围有所改善。
在轻度马德隆畸形病例中，该技术似乎安全可靠。
