Babu Satish, Turner Joseph, Seewoonarain Sheena, Chougule Sanjay
Frimley Park Hospital, Portsmouth Road, Frimley, United Kingdom.
East Surrey Hospital, Canada Avenue, Redhill, United Kingdom.
J Wrist Surg. 2019 Jun;8(3):176-179. doi: 10.1055/s-0039-1685488. Epub 2019 Apr 22.
Madelung's deformity of the wrist arises from premature closure of the medial and volar aspect of the distal radial physis. True Madelung deformities reveal the presence of a "Vickers" ligament which is a short, volar, radioulnar ligament. Clinically, patients report increasing deformity, pain, and poor range of motion. Radiological features include increased radial inclination, volar tilt of the distal radius, and a positive ulnar variance. Surgical intervention usually comprises either a "Vickers" ligament release and distal radius physiolysis or a radial dome osteotomy. In future, EOS Imaging could aid diagnosis by providing more detailed images of the deformity while minimizing radiation exposure. Furthermore, three-dimensional printing and computer-navigated deformity correction could revolutionize management by facilitating simulation training, expediting surgery, and reducing intraoperative error.
马德隆腕部畸形源于桡骨远端骨骺内侧和掌侧过早闭合。真性马德隆畸形显示存在一条“维克斯”韧带,它是一条短的、掌侧的桡尺韧带。临床上,患者会诉说畸形加重、疼痛以及活动范围受限。放射学特征包括桡骨倾斜度增加、桡骨远端掌侧倾斜以及尺骨正向变异。手术干预通常包括“维克斯”韧带松解和桡骨远端骨骺切开术或桡骨穹窿截骨术。未来,EOS成像技术可通过提供更详细的畸形图像同时将辐射暴露降至最低来辅助诊断。此外,三维打印和计算机导航畸形矫正技术可能会彻底改变治疗方式,通过促进模拟训练、加快手术进程以及减少术中误差来实现。