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

• Published in: Orthopaedics & traumatology, surgery & research Vol. 99; no. 4; pp. S279 - S283
• Main Authors: Mallard, F, Jeudy, J, Rabarin, F, Raimbeau, G, Fouque, P.-A, Cesari, B, Bizot, P, Saint-Cast, Y
• Format: Journal Article
• Language: English
• Published: France Elsevier Masson SAS 01-06-2013; Elsevier
• Subjects: Adult; Cohort Studies; Female; Growth Disorders - pathology; Growth Disorders - physiopathology; Growth Disorders - surgery; Humans; Life Sciences; Madelung; Orthopedics; Osteochondrodysplasias - pathology; Osteochondrodysplasias - physiopathology; Osteochondrodysplasias - surgery; Osteotomy - methods; Radius; Radius - surgery; Range of Motion, Articular; Recovery of Function; Surgery; Treatment Outcome; Wedge osteotomy; Wrist Joint - pathology; Wrist Joint - physiopathology; Young Adult; Radius; Wedge osteotomy; Madelung; Wrist Joint; Osteotomy; Humans; Treatment Outcome; Articular; Recovery of Function; Young Adult; Osteochondrodysplasias; Adult; Female; Growth Disorders; Cohort Studies; Range of Motion
• ISSN: 1877-0568; 1877-0568
• DOI: 10.1016/j.otsr.2013.03.007

Summary Madelung's deformity results from a growth defect in the palmar and ulnar region of the distal radius. It presents as an excessively inclined radial joint surface, inducing “spontaneous progressive palmar subluxation of the wrist”. The principle of reverse wedge osteotomy (RWO) consists in the reorientation of the radial joint surface by taking a circumferential bone wedge, the base of which is harvested from the excess of the radial and dorsal cortical bone of the distal radius, then turning it over and putting back this reverse wedge into the osteotomy so as to obtain closure on the excess and opening on the deficient cortical bone. RWO corrects the palmar subluxation of the carpus and improves distal radio-ulnar alignment. All five bilaterally operated patients were satisfied, esthetically and functionally. Its corrective power gives RWO a place apart among the surgical techniques currently available in Madelung's deformity.