A Rare Case of Reverse Madelung Deformity in a 10-year-old Girl Managed by Radio-Triquetral Ligament Excision, Radial Osteotomy, and Gradual Lengthening: Case Report and Literature Review
Introduction: Reverse Madelung deformity is an uncommon variant of Madelung deformity characterized by dorsal and ulnar angulation of the distal radius. Unlike the classical Madelung deformity, which usually presents as volar and ulnar deviation, reverse Madelung deformity can be easily mistaken for...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Indian Orthopaedic Research Group
2025-07-01
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| Series: | Journal of Orthopaedic Case Reports |
| Subjects: | |
| Online Access: | https://jocr.co.in/wp/2025/07/01/a-rare-case-of-reverse-madelung-deformity-in-a-10-year-old-girl-managed-by-radio-triquetral-ligament-excision-radial-osteotomy-and-gradual-lengthening-case-report-and-literature-review/ |
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| Summary: | Introduction:
Reverse Madelung deformity is an uncommon variant of Madelung deformity characterized by dorsal and ulnar angulation of the distal radius. Unlike the classical Madelung deformity, which usually presents as volar and ulnar deviation, reverse Madelung deformity can be easily mistaken for other wrist pathologies. This case report describes the successful management of a case of reverse Madelung deformity in a pediatric patient through the excision of a pathological radio-triquetral ligament, radial osteotomy, and gradual lengthening.
Case Report:
We report the case of a 10-year-old girl who presented with progressive deformity of the left wrist. Clinical examination revealed shortening of the radius, lateral subluxation of the ulna, and restricted wrist movement. Radiographic and MRI findings confirmed the diagnosis of reverse Madelung deformity. The patient underwent a two-staged surgical procedure, beginning with the excision of the pathological radio-triquetral ligament followed by radial diaphyseal osteotomy with gradual lengthening using an external fixator. Postoperatively, the patient showed significant improvement in wrist function, with the modified Mayo wrist score increasing from 60 to 95. Radiographic correction of the deformity was achieved, though a mild residual dorsal tilt remained. This tilt, if it causes any restriction of routine activities in the future, can be addressed after skeletal maturity.
Conclusion:
This case underscores the importance of accurate diagnosis and tailored surgical intervention in managing reverse Madelung deformity. Radial osteotomy with gradual lengthening with an external fixator proved effective in restoring function and correcting the deformity. Long-term follow-up is recommended to monitor for any residual deformity or functional issues. |
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| ISSN: | 2250-0685 2321-3817 |