Madelung Deformity: Understanding the Congenital Condition That Affects Adolescent Females

Learn about Madelung's Deformity, a congenital condition that impacts the growth of the distal radial physis in adolescent females involved in gymnastics. Discover its diagnosis, treatment options, and potential complications.

Madelung's Deformity is a congenital dyschondrosis of the distal radial physis that leads to partial deficiency of growth of the distal radial physis. It is a condition that primarily affects adolescent females, especially those involved in gymnastics.

Diagnosis

Diagnosis is made radiographically, with key findings including disruption of the ulnar volar physis of the distal radius, excessive radial inclination, excessive volar tilt, and ulnar carpal impaction.

Treatment

Treatment options vary depending on the symptoms of the patient. Asymptomatic individuals may choose observation, while those experiencing wrist pain, decreased range of motion, and/or functional limitations may require operative management.

Nonoperative Treatment

For asymptomatic individuals, observation is recommended. Restricted activity, especially activities with repetitive wrist impaction, should be followed until pain decreases.

Operative Treatment

Operative management may involve physiolysis with release of Vickers ligament, radial corrective osteotomy with or without distal ulnar shortening osteotomy, or DRUJ arthroplasty. The choice of procedure depends on the severity of the deformity, presence of wrist pain or decreased range of motion, cosmetic concerns, and functional limitations.

Complications

Potential complications of Madelung's Deformity include incomplete physiolysis or premature growth arrest, violation of radiocarpal or ulnocarpal joint, incomplete deformity correction, recurrent deformity, nonunion of the osteotomy site, and continued ulnar impaction (if radial osteotomy is performed alone).

Images