Presentation
Wrist pain and functional impairment for years. Painful when washing hair and wringing, although strength is maintained. Physical examination demonstrates ulnar positive variance on both sides.
Patient Data
Bowing of the radius, V-shaped proximal carpal row with the lunate at its apex, wedging between radius and ulna. Dorsal subluxation of the ulna. Findings are consistent with Madelung deformity. The pattern is observed in both wrists.
Status post ulnar shortening osteotomy performed to improve the function of the right hand.
Case Discussion
As in this case, Madelung deformity often leads to functional impairment and pain. Although conservative treatment tends to be ineffective, operative treatment (such as the ulnar osteotomy in this case) often has limited success.
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