Radioscapholunate Arthrodesis for Management of Madelung Deformity: A Case Report.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSCC/C401). 10. Chirurg. 2011 Jan;82(1):85-93; quiz 94. doi: 10.1007/s00104-009-1867-9. [Carpal instability]. [Article in German] Redeker J(1), Vogt PM. Author information: (1)Klinik für Plastische, Hand- und Wiederherstellungschirurgie, St. Barbara Hospital, Katholisches Klinikum Duisburg, Deutschland. J.Redeker@kkd.de Carpal instability can be understood as a disturbed anatomical alignment between bones articulating in the carpus. This disturbed balance occurs either only dynamically (with movement) under the effect of physiological force or even statically at rest. The most common cause of carpal instability is wrist trauma with rupture of the stabilizing ligaments and adaptive misalignment following fractures of the radius or carpus. Carpal collapse plays a special role in this mechanism due to non-healed fracture of the scaphoid bone. In addition degenerative inflammatory alterations, such as chondrocalcinosis or gout, more rarely aseptic bone necrosis of the lunate or scaphoid bones or misalignment due to deposition (Madelung deformity) can lead to wrist instability. Under increased pressure the misaligned joint surfaces lead to bone arrosion with secondary arthritis of the wrist. In order to arrest or slow down this irreversible process, diagnosis must occur as early as possible. Many surgical methods have been thought out to regain stability ranging from direct reconstruction of the damaged ligaments, through ligament replacement to partial stiffening of the wrist joint. DOI: 10.1007/s00104-009-1867-9