Clinical efficacy of distal radius dome osteotomy combined with Vickers ligament release in the treatment of Madelung′s deformity
10.3760/cma.j.cn101070-20240306-00132
- VernacularTitle:桡骨远端穹窿截骨合并Vickers韧带松解治疗马德隆畸形的临床疗效
- Author:
Liukun XU
1
;
Bo WANG
;
Wei LIAO
;
Zhan DONG
;
Zhiqun ZHANG
Author Information
1. 南京医科大学附属儿童医院骨科，南京 210019
- Keywords:
Madelung′s deformity;
Distal radius dome osteotomy;
Vickers ligament
- From:
Chinese Journal of Applied Clinical Pediatrics
2024;39(10):761-765
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical efficacy of the distal radius dome osteotomy combined with Vickers ligament release (DRO+ VR) in the treatment of Madelung′s deformity.Methods:A retrospective case series analysis.The clinical data of 15 children with Madelung′s deformity treated in the Children′s Hospital of Nanjing Medical University from January 2012 to August 2023 were collected, and the children were divided into the DRO+ VR group and the other operation group according to the surgical method.The follow-up time was recorded, and the ulnar tilt (UT), lunate subsidence (LS), palmar carpal displacement (PCD), lunate fossa angle (LFA), wrist flexion (WF), wrist extension (WE), and visual analogue scale (VAS) were measured before surgery and at the last follow-up.The independent samples t-test was used for measurement data comparison, and the Fisher′s exact test was used for categorical variable comparison. Results:The follow-up time was 10-96 months, with the time of (27.17±15.51) months in the DRO+ VR group and (48.00±24.06) months in the other operation group.There was no significant difference in preoperative general data, imaging indexes and functional evaluation between the 2 groups (all P>0.05).The comparison of imaging indexes and functional evaluation of children in the DRO+ VR group before surgery and at the last follow-up showed that the differences in UT [(49.00±3.10) ° vs.(31.83±2.40) °], LFA [(34.50±3.78) ° vs.(49.83±4.02) °], LS [(7.29±3.61) mm vs.(2.29±1.48) mm], PCD [(12.06±3.39) mm vs.(4.35±2.37) mm], WF [(61.17±1.47) ° vs.(67.50±3.33) °], WE [(48.67±1.86) ° vs.(60.50±4.42) °], and VAS [(7.33±1.03) points vs.(2.67±0.52) points] were statistically significant (all P<0.05).At the last follow-up, the results of imaging indexes and functional evaluation of the 2 groups showed that the improvement of UT was (17.17±2.32) ° in the DRO+ VR group and (51.78±7.66) ° in the other operation group, which had statistically difference ( t=-2.241, P=0.043). Conclusions:DRO+ VR is an effective approach for treating Madelung′s deformity in children.It can significantly improve children′s imaging indexes and wrist joint function and alleviate pain symptoms.Surgical intervention should be actively considered for patients with severe deformity and pain symptoms related to Madelung′s deformity.
