Madelung deformity

Case contributed by Garvit D Khatri
Diagnosis certain

Presentation

Patient presented with chief complaints of bilateral forearm deformity and difficulty in hand gripping. The symptoms were progressive since last 3-4 years.

Patient Data

Age: 12
Gender: Female
x-ray

X ray AP and lateral view of both forearms of a 12 year old female with classic Madelung deformity. There was bilateral shortening of radius bones with dorsal and radial bowing. Moreover, there was V-shaped proximal carpal row and positive ulnar variance. The pisiform appears impacted, which can cause ulnar impaction.

Case Discussion

Madelung deformity is caused by epiphyseal growth plate disturbance at the ulnar side of distal radius, resulting in a short radius compared with the ulna. The growth plate injury may be vascular, infectious, traumatic or muscular. Syndromes like nail-patella, Turner, Leri-Weill, Madelung dyschondrosteosis, and others maybe associated with the deformity. Treatment options are mainly surgical: radial/ulnar eiphysiodesis or corrective osteotomies and vicker ligament release.    

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