McCarroll H Relton, James Michelle A
Shriners Hospital for Children Northern California, Sacramento, CA, USA.
Tech Hand Up Extrem Surg. 2010 Jun;14(2):85-93. doi: 10.1097/BTH.0b013e3181dba5fe.
Madelung's deformity results from arrested or slowed growth of the volar-palmar portion of the distal radial epiphysis. The deformity is characterized by increased volar and ulnar tilt of the articular surface of the radius and a bow of the distal radius in a palmar direction. When Madelung's deformity produces pain and interferes with function, correction of the deformity of the radius and secondary overgrowth of the ulna is desirable. Although osteotomy of the radius near the junction of the middle and distal thirds allows correction of the bow of the radius and limited correction of palmar tilt, it does not permit correction of ulnar tilt. We describe a very distal radial osteotomy that permits correction of the 3 deformities of the distal radius independently; correction of palmar tilt, ulnar tilt, and the bow of the radius are selected individually. The inherent flexibility makes the procedure technically challenging but allows for maximum independent correction of the components of Madelung's deformity. Early results indicate the procedure provides relief of pain and improved appearance with few complications.
马德隆畸形是由桡骨远端骨骺掌侧部分生长停滞或缓慢所致。该畸形的特征是桡骨关节面掌侧和尺侧倾斜增加，以及桡骨远端向掌侧成弓形。当马德隆畸形引起疼痛并影响功能时，矫正桡骨畸形和尺骨继发性过度生长是可取的。尽管在中、远三分之一交界处附近的桡骨截骨术可以矫正桡骨的弓形并有限地矫正掌侧倾斜，但它不能矫正尺侧倾斜。我们描述了一种非常远端的桡骨截骨术，该术式可以独立矫正桡骨远端的三种畸形；掌侧倾斜、尺侧倾斜和桡骨弓形可分别进行矫正。其固有的灵活性使该手术在技术上具有挑战性，但能最大程度地独立矫正马德隆畸形的各个组成部分。早期结果表明，该手术能缓解疼痛、改善外观，且并发症较少。
