dos Reis F B, Katchburian M V, Faloppa F, Albertoni W M, Laredo Filho J
Department of Orthopaedics and Traumatology, Federal University of São Paulo, Brazil.
J Bone Joint Surg Br. 1998 Sep;80(5):817-24. doi: 10.1302/0301-620x.80b5.8691.
The Madelung deformity can result in pain and decreased function of the wrist and hand. None of the surgical techniques available has been shown consistently to improve grip strength, range of movement or relieve pain. In this prospective study we have treated 18 patients with the Madelung deformity (25 wrists) by wedge subtraction osteotomy of the radius and shortening of the ulna. Our results show statistically significant improvement in grip strength and range of movement of the wrist and forearm. Pain improved in 80% of the patients and 88% were satisfied with the appearance. One patient had a wound infection and another developed reflex sympathetic dystrophy. Two had some recurrence due to continued growth of the ulna and it is recommended that the procedure be delayed until skeletal maturity, or else combined with epiphysiodesis of the ulna.
马德隆畸形可导致腕部和手部疼痛及功能下降。现有的手术技术均未始终如一地显示能改善握力、活动范围或缓解疼痛。在这项前瞻性研究中，我们对18例马德隆畸形患者（25个腕关节）采用桡骨楔形截骨术和尺骨缩短术进行治疗。我们的结果显示，腕部和前臂的握力及活动范围有统计学上的显著改善。80%的患者疼痛得到改善，88%的患者对外观满意。1例患者发生伤口感染，另1例出现反射性交感神经营养不良。2例因尺骨持续生长出现了一些复发情况，建议该手术推迟至骨骼成熟时进行，否则可结合尺骨骨骺固定术。
