University of Amsterdam, The Netherlands.
University of Montpellier, France.
Hand (N Y). 2023 Mar;18(2_suppl):17S-23S. doi: 10.1177/15589447211017223. Epub 2021 Jun 6.
Madelung deformity is a rare wrist anomaly that causes considerable pain while restricting function. In this study, we describe a radioscapholunate (RSL) arthrodesis with a neo-distal radioulnar joint (DRUJ) in Madelung deformity patients with an abnormal sigmoid notch and compare results to patients after a reverse wedge osteotomy.
Six wrists underwent RSL arthrodesis with a neo-DRUJ in a two-phase approach: (1) modified RSL arthrodesis with triquetrectomy; and (2) distal scaphoidectomy. Seven wrists underwent a reverse wedge osteotomy procedure.
There were no differences found in postoperative pain, grip strength, or range of motion (ROM), apart from extension, which was decreased after RSL arthrodesis with a neo-DRUJ. Quality of life and Michigan Hand Outcomes Questionnaire scores were similar.
Although clinical outcome parameters are not different among the two groups, the RSL arthrodesis with construction of a neo-DRUJ could prove a valid treatment option for a subset of patients with a severely affected sigmoid notch.
Madelung 畸形是一种罕见的腕关节畸形，会导致严重疼痛并限制功能。在这项研究中，我们描述了一种在伴有异常月状骨切迹的 Madelung 畸形患者中进行桡腕关节（RSL）融合和新的远端桡尺关节（DRUJ）的方法，并将结果与反向楔形截骨术后的患者进行了比较。
6 例腕关节采用两阶段方法进行 RSL 融合和 neo-DRUJ：（1）改良 RSL 融合伴三角纤维软骨复合体切除术；和（2）远排腕骨切除术。7 例腕关节行反向楔形截骨术。
除了 RSL 融合和 neo-DRUJ 后伸展度降低外，两组在术后疼痛、握力或活动范围（ROM）方面均无差异。生活质量和密歇根手功能问卷评分相似。
尽管两组的临床结果参数没有差异，但 RSL 融合和 neo-DRUJ 的构建可能是一组严重月状骨切迹畸形患者的有效治疗选择。
