Abstract
Madelung deformity (MD) comprises an increased volar and ulnar tilt of the joint facet
of the distal radius, secondary to an idiopathic physeal dysplasia. Such change causes
radial shortening and consequent distal ulnar prominence, along with wrist pain and
loss of motion. Surgery becomes an option in patients with severe deformity that do
not respond to conservative treatment.
The classic surgical techniques are problematic for adults, as they are specific for
children and adolescents, whose radial physis is still open. Very few papers discuss
the treatment of adult patients; furthermore, most are focused on the distal radioulnar
joint, and thus do not approach the origin of the pathology.
When analyzing computed tomography scans with tridimensional reconstruction, a feature
of MD, growth arrest of the volar and ulnar portions of the distal radius, is noted,
causing the typical distal radius deformity that leads to lack of coverage of the
lunate bone. That leads to palmar subluxation of the lunate bone and consequent radiocarpal
instability.
We herein describe the possibilities of treatment in different stages of evolution,
summarizing the authors' view on MD.
Keywords
Madelung deformity - longitudinal dysplasia - wrist subluxation - congenital hand
anomalies - historical perspective
