Reverse wedge osteotomy of the distal radius in Madelung's deformity.

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Abstract

[Indexed for MEDLINE] 19. Hand (N Y). 2023 Mar;18(2_suppl):17S-23S. doi: 10.1177/15589447211017223. Epub 2021 Jun 6. Madelung Deformity: Radioscapholunate Arthrodesis With a Neo-DRUJ. Piek AR(1), Peymani A(1), Dobbe JGG(1), Buijze GA(1)(2), Chammas M(2), Streekstra GJ(1), Strackee SD(1). Author information: (1)University of Amsterdam, The Netherlands. (2)University of Montpellier, France. BACKGROUND: Madelung deformity is a rare wrist anomaly that causes considerable pain while restricting function. In this study, we describe a radioscapholunate (RSL) arthrodesis with a neo-distal radioulnar joint (DRUJ) in Madelung deformity patients with an abnormal sigmoid notch and compare results to patients after a reverse wedge osteotomy. METHODS: Six wrists underwent RSL arthrodesis with a neo-DRUJ in a two-phase approach: (1) modified RSL arthrodesis with triquetrectomy; and (2) distal scaphoidectomy. Seven wrists underwent a reverse wedge osteotomy procedure. RESULTS: There were no differences found in postoperative pain, grip strength, or range of motion (ROM), apart from extension, which was decreased after RSL arthrodesis with a neo-DRUJ. Quality of life and Michigan Hand Outcomes Questionnaire scores were similar. CONCLUSIONS: Although clinical outcome parameters are not different among the two groups, the RSL arthrodesis with construction of a neo-DRUJ could prove a valid treatment option for a subset of patients with a severely affected sigmoid notch. DOI: 10.1177/15589447211017223 PMCID: PMC10052619