Sunday, February 3, 2019

Madelungs Deformity Surgical Technique

I have posted a few times on Madelung Deformity, as may be seen HERE.  While there have been a number of surgical techniques recommended over the years, I believe that the dome osteotomy of the distal radius is the best option.  That procedure was described well in this important MANUSCRIPT.

Below is a brief surgical technique video on the dome osteotomy for Madelung Deformity.   While this is not a truly graphic video (no notable blood loss), it does provide a look inside the forearm and shows how this procedure is performed with drills, wires, and chisels (osteotomes).  What I mean to say is that everyone may not want to watch this!

I use this surgery for Madelung Deformity when patients have pain in the central wrist or radial wrist (thumb size).  That is typically in younger patients (example, 12 year old female) and may be part of a surgery which includes excision of Vickers ligament and physiolysis.  However, in older patients with pain on the pinky side of the wrist (the ulnar side), this may not be the best option- instead, an ulnar shortening osteotomy might be the ideal surgery.




Thanks to Andrew Yee for his expertise in creating this video!


Charles A. Goldfarb, MD
My Bio at Washington University
Email me: congenitalhand@wudosis.wustl.edu

2 comments:

  1. hello I am a 41 year old female with madelung deformity in both arms my symptoms presented since I was about 12 years old I am having pain numbness and I am looking into having surgery if you have any recommendations I would greatly appreciate it

    ReplyDelete
    Replies
    1. Hello. Often the pain is on the pinky side of the wrist once you are fully grown. If that is the case, shortening the ulna bone can help. I would recommend seeing a hand surgeon with experience in this area. Good luck.

      Delete