Early outcome in Madelung’s and Madelung like deformity of wrist in adolescent group

Abstract

<p class="abstract"><strong>Background:</strong> Madelung deformity is the result of bony and ligamentous dysplasia at the wrist that produces characteristic deformity and is usually recognized in late adolescence. Madelung like deformity can occur following trauma, infection or neoplasm. This esthetic deformity is encountered rarely in orthopaedic practice, when surgeon faces the challenging task to correct it using the best available technique. This study has been conducted to analyze the presentation, interventional procedures and their end result.</p><p class="abstract"><strong>Methods:</strong> We retrospectively analyze the clinical records, radiographs and functional outcome of patients who presented with Madelung and Madelung like deformity. Radiographic and clinical assessment was done. Surgery was considered for patients fitting into the inclusion criteria. Dorsolateral close wedge and palmar open wedge osteotomy of radius were done with or without ulnar procedure. Postoperative protocol was followed and periodic assessment was done. Mayo modified wrist score has been used to evaluate the pre-operative and post-operative scores.<strong></strong></p><p class="abstract"><strong>Results:</strong> The study enrolled sixteen affected wrists. Average age in our study was 14 years with an average follow-up of 12 months. Statistically significant increase in range of motion of wrist was achieved for in surgically treated patients. Significant change in pain score, grip strength, RAU° and carpal slip was noted. Postoperative wrist score was also significantly improved.</p><p><strong>Conclusions:</strong> Our study concludes that there is a definitive role of surgical intervention to improve the range of motion of wrist, grip strength and reduces pain which brings the patient back into the main stream of a functionally independent being. </p>