Purpose
Surgical treatment of Madelung deformity can present challenges due to a need for
multiplanar correction. Developing customized cutting guides for osteotomies may improve
surgical outcomes by enhancing the surgeon’s understanding and surgical correction.
Methods
All patients who underwent forearm osteotomies for Madelung deformity using computed
tomography planning with 3-dimensional–printed customized cutting guides were retrospectively
reviewed (n = 8). Seven patients underwent a double osteotomy of the radius, and 1
underwent a single osteotomy.
Results
Ulnar tilt was improved in all cases. Correction of deformity was significant on anteroposterior
but not on lateral views. The mean preoperative and postoperative radial bow was measured
in 2 planes, with an average preoperative bow of 32° (± 21°) on anteroposterior radiographs
and 36° (± 17°) on lateral radiographs, and an average bow of 10° (± 6°) on anteroposterior
radiographs and 7° (± 6°) on lateral films after surgery. The predicted radial bow
was calculated to be 9.1° (± 8°).
Conclusions
Three-dimensional planning allows predictable deformity correction across multiple
but not all parameters. Future studies comparing clinical and radiographic outcomes
of guided versus nonguided osteotomies are required to justify the additional expense
and preoperative planning efforts.
Type of study/level of evidence
Therapeutic V.
Key words
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References
- Madelung’s deformity: a spectrum of presentation.J Hand Surg Am. 2007; 32: 1393-1401
- Madelung’s deformity. A follow-up study of 26 cases and a review of the literature.Acta Orthop Scand. 1977; 48: 379-384
- Madelung deformity: surgical prophylaxis (physiolysis) during the late growth period by resection of the dyschondrosteosis lesion.J Hand Surg Br. 1992; 17: 401-407
- Madelung deformity.J Hand Surg Am. 2015; 40: 2090-2098
- MRI appearance of the anomalous volar radiotriquetral ligament in true Madelung deformity.Skeletal Radiol. 2019; 48: 915-918
- Madelung and the recognition of Madelung’s deformity.J Hand Surg Am. 2006; 31: 177-182
- Treatment of Madelung deformity with Vicker ligament release and radial physiolyses: a case series.J Hand Surg Am. 2019; 44: 158.e1-158.e9
- Volar ligament release and distal radius dome osteotomy for correction of Madelung’s deformity.J Hand Surg Am. 2006; 31: 1499-1506
- Madelung deformity and Madelung-type deformities: a review of the clinical and radiological characteristics.Pediatr Radiol. 2015; 45: 1856-1863
- Volar ligament release and distal radial dome osteotomy for the correction of Madelung deformity: long-term follow-up.J Bone Joint Surg Am. 2013; 95: 1198-1204
- Radiographic criteria for undergoing an ulnar shortening osteotomy in Madelung deformity: a long-term experience from a single institution.J Pediatr Orthop. 2016; 36: 310-315
- Osteotomy of the radius and ulna for the Madelung deformity.J Bone Joint Surg Br. 1998; 80: 817-824
- Four-dimensional rotational radiographic scanning of the wrist in patients after proximal row carpectomy.J Hand Surg Eur Vol. 2017; 42: 846-851
- 3D planning and patient-specific surgical guides in forearm osteotomy in children: radiographic accuracy and clinical morbidity.Orthop Traumatol Surg Res. 2022; 108102925
- Why and how to report surgeons’ levels of expertise.J Hand Surg Eur Vol. 2016; 41: 365-366
- Madelung’s deformity: quantitative assessment of x-ray deformity.J Hand Surg Am. 2005; 30: 1211-1220
- The recurrence of deformity after surgical centralization for radial clubhand.J Hand Surg Am. 2000; 25: 745-751
- Centralization of the radial club hand: an ulnar surgical approach.J Hand Surg Am. 1981; 6: 423-433
- Intraclass correlations: uses in assessing rater reliability.Psychol Bull. 1979; 86: 420-428
- Quantitative three-dimensional assessment of Madelung deformity.J Hand Surg Eur Vol. 2019; 44: 1041-1048
- Very distal radial osteotomy for Madelung’s deformity.Tech Hand Up Extrem Surg. 2010; 14: 85-93
- Three-dimensional printing technology in orthopaedics.J Am Acad Orthop Surg. 2019; 27: 918-925
- Madelung’s deformity: diagnostic thresholds of radiographic measurements.J Hand Surg Am. 2010; 35: 807-812
- Madelung’s deformity: quantitative radiographic comparison with normal wrists.J Hand Surg Eur Vol. 2008; 33: 632-635
- Isolated Madelung’s deformity: long-term follow-up study of five patients treated surgically.J Pediatr Orthop B. 2007; 16: 331-335
Article info
Publication history
Published online: February 09, 2023
Accepted:
December 14,
2022
Received:
November 22,
2020
Publication stage
In Press Corrected ProofFootnotes
No benefits in any form have been received or will be received related directly to this article.
Identification
Copyright
© 2023 by the American Society for Surgery of the Hand. All rights reserved.
