Madelung Deformity: Radioscapholunate Arthrodesis With a Neo-DRUJ.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. 20. J Pediatr Orthop. 2026 Mar 1;46(3):172-179. doi: 10.1097/BPO.0000000000003143. Epub 2025 Oct 24. Treatment Decision-making in Madelung Deformity: A Retrospective Review of 74 Wrists. Martínez-Álvarez S(1), García-Fernández J(1), Galán-Olleros M(1), Arias-Martínez P(2), Teodonno F(3), Vara-Patudo I(1), Palazón-Quevedo Á(1). Author information: (1)Department of Orthopaedic Surgery and Traumatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain. (2)Biomedical Research Foundation of the Hospital Infantil Universitario Niño Jesús, Madrid, Spain. (3)Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Rey Juan Carlos, Madrid, Spain. INTRODUCTION: Madelung deformity is a rare wrist condition characterized by progressive angular deformity secondary to asymmetric premature closure of the distal volar-ulnar radial physis. Standardized treatment guidelines remain lacking. This study aimed to evaluate clinical and radiologic outcomes following different surgical strategies and to identify key parameters to guide surgical decision-making. METHODS: A retrospective review was performed on 74 wrists in 41 patients treated between 1999 and 2023. Data collected included demographics, range of motion (ROM), and radiographic parameters: ulnar tilt (UT), lunate fossa angle (LFA), lunate subsidence (LS), and palmar carpal displacement (PCD), assessed preoperatively and postoperatively. RESULTS: Of 74 wrists, 56 (75.7%) underwent surgical treatment: 33 (44.6%) received Vickers ligament resection (VLR) at a mean age of 11.3 ± 2.5 years, and 23 (31.1%) underwent radial dome osteotomy (RDO) at 13.0 ± 1.9 years. RDO was indicated in patients presenting with marked ROM limitations (>20 degrees), LS ≥ 7.2 mm, and PCD ≥ 25.7 mm ( P