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Madelung’s Deformity in Children

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The Pediatric Upper Extremity

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Abstract

The exact etiology of Madelung’s deformity is not known. In addition, the clinical and radiographic presentation can vary greatly between not only patients but also between forearms in the same patient. In severe cases, the premature closure of the volar-ulnar physis of the distal radius leads to the characteristic appearance of volar subluxation of the hand/carpus as well as a dorsally prominent ulna. In some cases, a genetic component is present in the form of Leri-Weill syndrome in which there is an abnormality in the short-stature homeobox gene (SHOX) (Benito-Sanz S, Thomas NS, Huber C, Am J Hum Genet 77:533–544, 2005). Symptoms can include pain, decreased wrist/forearm ROM, as well as cosmetic dissatisfaction with appearance.

It is important to assess and counsel every patient individually as not everyone will need surgical intervention. If the patient has no symptoms and the deformity is minimal, then careful observation with serial examinations and radiographs is warranted. If the deformity is more severe and symptoms are present, then operative intervention may be warranted. Depending on the age of the patient and deformity present, several types of operative treatment are available. The results following surgery for Madelung’s deformity have consistently been shown to be of benefit and should be considered for symptomatic patients with substantial deformity.

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Acknowledgments

The authors wish to recognize the work of previous author Lesley Wheeler, MD, and colleagues for their contributions to The Pediatric Upper Extremity and to this manuscript.

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Authors and Affiliations

  1. Department of Hand Surgery, Texas Scottish Rite Hospital for Children, Dallas, TX, USA

    Scott N. Oishi, Arena Sayavong & Marybeth Ezaki

Authors
  1. Scott N. Oishi
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  2. Arena Sayavong
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  3. Marybeth Ezaki
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Corresponding author

Correspondence to Scott N. Oishi .

Editor information

Editors and Affiliations

  1. Dept. of Orthopedics, U. of Maryland School of Medicine, Timonium, MD, USA

    Joshua M. Abzug

  2. Shriners Hospital for Children - Phila., Philadelphia, PA, USA

    Scott Kozin

  3. Shriners Hospital For Children - Phila., Philadelphia, PA, USA

    Dan A. Zlotolow

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Oishi, S.N., Sayavong, A., Ezaki, M. (2023). Madelung’s Deformity in Children. In: Abzug, J.M., Kozin, S., Zlotolow, D.A. (eds) The Pediatric Upper Extremity. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8758-6_81-2

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  • DOI: https://doi.org/10.1007/978-1-4614-8758-6_81-2

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-8758-6

  • Online ISBN: 978-1-4614-8758-6

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Chapter history

  1. Latest

    Madelung’s Deformity in Children
    Published:
    09 October 2023

    DOI: https://doi.org/10.1007/978-1-4614-8758-6_81-2

  2. Original

    Madelung’s Deformity
    Published:
    20 June 2014

    DOI: https://doi.org/10.1007/978-1-4614-8758-6_81-1

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