Department of Pediatric Orthopedics and Foot and Ankle Surgery, Orthopedic Hospital Speising, Vienna, Austria.
Servicio de Cirugía Ortopédica y Traumatología Infantil, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.
J Hand Surg Eur Vol. 2021 May;46(4):384-390. doi: 10.1177/1753193420981522. Epub 2021 Jan 17.
In a retrospective multicentre study, we aimed to correlate clinical factors and findings on plain radiographs and MRI with the intraoperative presence of Vickers' ligament in Madelung's deformity. We screened the records, in which the absence or presence of Vickers' ligament was affirmatively indicated, of 75 consecutive operated extremities in 58 patients. In 83% a Vickers' ligament was observed intraoperatively. The whole bone Madelung type (as opposed to the distal type) and a distal radial notch were independent, significant predictors for the presence of the ligament. The correct Vickers detection rate using MRI was 85% of the 27 cases for which MRI was available. Thus, the MRI was a good but not perfectly reliable modality. We conclude that Vickers' ligament is present in the majority but not all cases with Madelung deformity. We advise that patients with a more severe type of Madelung's deformity and a distal radial notch should be monitored closely. IV.
在一项回顾性多中心研究中，我们旨在将影像学上的临床因素和发现与马德隆畸形中 Vickers 韧带的术中存在相关联。我们筛选了 58 名患者的 75 个连续手术肢体的记录，这些记录中明确指出了 Vickers 韧带的存在或不存在。在 83%的病例中，术中观察到了 Vickers 韧带。全骨马德隆型（与远端型相反）和桡骨远端切迹是韧带存在的独立、显著预测因素。在 27 例可进行 MRI 检查的病例中，MRI 正确检测 Vickers 韧带的比例为 85%。因此，MRI 是一种良好但并非完全可靠的方法。我们的结论是，Vickers 韧带存在于大多数马德隆畸形病例中，但并非所有病例中。我们建议，对于更严重类型的马德隆畸形和桡骨远端切迹的患者，应密切监测。IV.
