The result of correction osteotomy of the radius and shortening osteotomy of the ulna for Madelung Deformity and literature review.

Year 2017, , 119 - 124, 19.04.2017

Ahmet Salduz , Murat Korkmaz , Kayahan Karaytuğ , Ömer Naci Ergin Hayati Durmaz

https://doi.org/10.21673/anadoluklin.296594

Abstract

Background: Madelung deformity is a rare condition characterized by premature
growth arrest of the volar–ulnar aspect of the distal radius growth plate. Different
surgical procedures are described in the literature. In this study, we aim to
present functional and clinical results of our technique in five wrists of 4
patients.

Methods: 5 wrists of 4 patients (3 females and 1 male) underwent surgery for
Madelung deformity in our clinic between 2005-2014. Mean age of the patients
was 15,4 (14-17) and mean follow up duration was 65,6 months (29-111). One
patient had bilateral deformity. Patients were evaluated with wrist ROM, DASH
and VAS score pre and post-operatively. Corrective osteotomy to the radius,
shortening osteotomy to the ulna and release of the Vickers ligament were
performed on all patients.

Results: Although there were no meaningful changes in the range of supination-pronation;
palmar flexion was decreased; and dorsiflexion and radial deviation were significantly
higher in the last follow-up compared to the preoperative values. Union was
achieved at the all osteotomy sites. All radiological parameters were
significantly better in the last follow-up x-rays. Preoperative and
postoperative mean DASH score was 55,4 and 18,8, respectively and preoperative
and postoperative mean VAS score was 6 and 1, respectively.

Conclusions:
This surgical technique may be a good option for
severe Madelung deformity in terms of functional and radiological results and patient
satisfaction in the midterm follow-up. Pain and gross deformity were our main
surgical indications.

Keywords

Madelung deformity, Osteotomy, Wirst, Radius, Ulna

Madelung Deformitesinde Radius Düzeltici, Ulna Kisaltıcı Osteotomi Sonuçları: Olgu serisi

Abstract

Amaç: Madelung deformitesi, radius distal büyüme plağının volar ve ulnar
tarafında erken büyüme duraklaması ile tanımlanan nadir bir deformitedir.
Literaturde farklı cerrahi girişimler tanımlanmıştır. Bu çalışmada Madelung
deformitesinde kullandığımız cerrahi tekniğin klinik ve radyolojik sonuçlarını
değerlendirmeyi amaçladık. 

Gereç ve Yöntem: 2005-2014 yılları arasında kliniğimzide dört hastanın 5 elbileği (3 bayan, 1 erkek) Madelung deformitesi
nedeni ile opera edildi. Hastaların ortalama yaşı 15.4 (14-17) ve ortalam takip
süresi 65 (29-111) ay idi. Bir hastada bilateral deformite vardı. Hastalar
ameliyat öncesi ve sonrası eklem hareket açıklığı, DASH ve VAS skorları ile
değerlendirildi. Tüm hastalara radius düzeltici osteotomi, ulna kısaltıcı
osteotomi ve vicker ligaman gevşetme ameliyatı yapıdı.

Sonuçlar: Hastaların son kontrollerindeki eklem hareket açıklıkları ameliyat
öncesi değerler ile karşılaştırıldığında; dorsifleksiyon ve radial deviasyon
aralığı anlamlı olarak artarken palmar fleksiyon arkı azaldı. Supinasyon ve
pronasyon aralığında anlamlı bir değişiklik izlenmedi. Tüm osteotomi alanlarında kaynama izlendi. Son takip
röntgenlerinde tüm radyolojik parametreler ameliyat öncesine göre anlamlı
olarak daha iyiydi. Ameliyat öncesi ve sonrası ortalama DASH skoru sırasıyla
55.4 ve 18.8 iken, ameliyat öncesi ve sonrası VAS skoru sırasıyla ortalama 6 ve
1 idi. 

Çıkarımlar: İleri Madelung deformitesi olan hastalarda bu cerrahi teknik hasta
memnuniyeti, fonksiyonel ve radyolojik sonuçlar bakımından iyi bir seçenek
olabilir. Ağrı ve belirgin deformite bizim ana cerrahi
endikasyonumuz oldu. 

Keywords

Madelung deformitesi, Osteotomi, Elbileği, Radius, Ulna

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