Contemporary Advances in the Management of Madelung Deformity

Dr. Nishant

Abstract: Madelung deformity is a three-dimensional growth disturbance of the distal radius characterized by volar-ulnar deficiency of the lunate facet, progressive radial bowing, carpal malalignment, and relative ulnar overgrowth. Management has shifted from procedure-based correction toward phenotype-, maturity-, and symptom-directed reconstruction. This narrative review summarizes contemporary advances in diagnosis, surveillance, surgical planning, and operative treatment, emphasizing developments reported during the past decade. Standardized radiographs remain the basis of assessment, while magnetic resonance imaging can identify the anomalous volar radiolunate or radiotriquetral tether and evaluate cartilage and triangular fibrocartilage complex pathology. Genetic evaluation for SHOX haploinsufficiency and associated dysplasias is increasingly relevant when deformity is bilateral or syndromic. In growing children with early disease, Vickers ligament release and physiolysis may reduce tethering and permit partial growth correction, although recurrence and progression remain possible. In established deformity, corrective radial osteotomy?dome, opening or closing wedge, or reverse wedge?remains the principal reconstructive procedure. Ulnar shortening, epiphysiodesis, or distal radioulnar joint salvage should be selected according to ulnar variance, maturity, articular congruity, and the dominant pain generator. Three-dimensional computed-tomography simulation, printed models, and patient-specific cutting or drilling guides allow multiplanar correction and may improve execution in severe or whole-bone deformity, but evidence is limited to small retrospective series and technical reports. The current literature supports durable pain relief after appropriately selected reconstruction but does not establish superiority of one osteotomy. Future multicenter prospective studies should use standardized radiographic measures, patient-reported outcomes, skeletal-maturity reporting, and long-term assessment of recurrence and arthritis.

Keywords: Madelung deformity; distal radius; Vickers ligament; osteotomy; ulnar variance; three-dimensional planning; SHOX

How to Cite?: Dr. Nishant, "Contemporary Advances in the Management of Madelung Deformity", Volume 15 Issue 8, August 2026, International Journal of Science and Research (IJSR), Pages: 2020-204, https://www.ijsr.net/getabstract.php?paperid=SR26829094913, DOI: https://dx.doi.org/10.21275/SR26829094913

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