Madelung's deformation: Presentation Spectrum (2023)

Madelung's surgical treatment can be a challenge due to the need for multi -flexible correction. The development of individualized cuts to osteotomy can improve surgical results by better understanding of surgeon and surgical correction.

All patients who underwent forearm osteotomy due to Madelung deformity using computed tomography planning with three-dimensional, customized cutting guides (n = 8) were analyzed retrospectively. Seven patients have a double radial osteotomy and one single.

The elbow tilt is improved in all cases. Deformation Core was significant in the front-thin case, but not in the case of lateral views. Pre-operative and postoperative radial arcs measured at 2 levels with an average pre-operative nod 32 ° (± 21 °) on frontal radiograms -it and 36 ° (± 17 °) on side radiographs and a medium arc 10 ° (± 6 ° ) on a frontal X-ray and 7 ° (± 6 °) on a lateral film after the operation. ° (± 8 °).

Three-dimensional planning enables predictable correction of deformity in relation to many but not all parameters. Future research is needed to compare clinical and radiological results of directed and non-directed osteotomy to justify additional expense and effort related to preoperative planning.

Therapeutic V.

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There is a significant female advantage of Madelung deformity congenital dyschondrosis in the distal radius leads to a partial distal lack of the growth plate and volar, which can result in increased radial, volar and ulnar tilt of the radio carped, proximal and deportal migration in the proximal idech,However, dorsal and ulnar wrist effect [5-8] Ethiology is unclear, mainly attributed to inadequate distal vascular radius and abnormalities of the musculature and the rating of the distal radial fibrous apparition [7.9-11].

The most important pathology in Madelung deformity is a partial growth deficiency in the distal radius and Palmar cartilage plate.For surgical treatment, the Taylor Spatial Frame (TSF) external fixator can be used, which provides at the same time multiplanar correction and extension after radius osteotomy, which protects the Vickers League and the elbow.We sought to evaluate the radiological and functional results of correction of Madelung deformities with TSF by retrospective to analyze eight Madelung deformities in seven patients between August 2011 and May 2015. The average age was 14.8 years (interval 11-26) and the averageFollow-up was 35 years .1 months (24-78).We evaluated demographics and pre- and postoperative radiological and functional findings.The average preoperative visual analog pain score improved from 7.7 to 1.6.The average preoperative dash score improved from 19.1 (9.5-46.6) to 3.7 (2.3-6.8).The average preoperative radial length was improved from 184 mm (138-209) to 196 mm (142-213).We believe that Software Correction with TSF is a safe solution to Madelung deformity, with minimal error margin and risk of postoperative stiffness and infection.

IV.

Partial growth deficiency in the radial and volar portions of the distal radius growth plate is the main cause of Madelung deformity. Surgical treatment of the Madelung deformity can be performed with Taylor Spatial Frame (TSF) external fixators, which allow simultaneous, multiplanar correction and lengthening after radius osteotomy with preservation of the Vicker's ligament and ulna. We sought to evaluate the radiological and functional results of the correction of Madelung deformity using the TSF method. We retrospectively analyzed eight Madelung deformities in seven patients between August 2011 and May 2015. Mean age was 14.8 months (11–26), mean follow-up was 35.1 months (24–78). We assessed demographics, pre- and postoperative radiological and functional findings. The mean preoperative pain score (VAS) improved from 7.7 to 1.6. The mean preoperative DASH score improved from 19.1 (9.5–46.6) to 3.7 (2.3–6.8). The mean preoperative radial length improved from 184 mm (138–209) to 196 mm (142–213). We believe that TSF software correction can be safely applied to Madelung deformity with minimal margin of error and risk of postoperative stiffness and infection.

Iv.

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In modern cases, medical treatment causes a lower degree of bone deformity Although still showing reduced dimensions, the elbows are often not affected (cf. Zebala et al., 2007, Kouassi Koame2016). In less extreme cases, muscle weakness and failure associated with radius deformity and subluxation of the Radioulnaru joint can lead to a reduction in dimensions.

This article presents a probable case of a Madelung-type deformity of the right forearm in a unit from a Merovingian burial site (7th and 8th centuries) in Gotha-Boilstädt (Germany).

The study involved a woman aged 40-50 years at the age of death.

Macroscopic, osteometric and radiographic analyzes were performed using standard methods.

The person has an unusual case of the upper limb to the right.

The results indicate that the device may have been affected by one -sided Madelung deformation.The cutting of this case is greater than reported in clinical literature.

This study places an ancient rare disease in archaeological and palaeopathological contexts, making it possible to evaluate the concept of "old rare disease".It also emphasizes the importance of reporting strictly diagnosed cases to raise our awareness of the occurrence and course of this rare illness in the past.

The diagnosis cannot be determined with certainty and only a handful of possible diagnoses can be offered innate and acquired etiologies, especially compared to clinical cases where the severity of the conditions can be modified by medical intervention.

Genetic analysis may be helpful in determining the etiology of the observed Madelung deformity.

In Madelung's deformation, various skeletal and soft tissue abnormalities were identified and the hypothesis was placed that they play a causal role in its progressive symptomatology; However, our pathological understanding of these changes remains limited. In this study, we evaluated the wrist with Madelung's deformation biomechanically using imaging of 4-dimensional computed tomography.

Nine Madelunga deformity wrists (5 patients; age, 24 ± 5 ​​years) and 18 healthy wrists (9 volunteers; age, 28 ± 3 years) have 4-dimensional imaging during the flexion and radio-extension motion. Carbitrism of the wrist and wrist Parameters of the radiocarpal joint have been determined quantitatively and compared.

In the wrists with Madelung's deformity, significantly reduced rotation was observed at the lunate (-4.6°) and triangular (-4.8°) mandibular rotation during flexion-extension. During radioulnar deviation, there were significant decreases in lunate translation (–0.7 mm), triangular translation (–0.6 mm), and triangular bone rotation (–1.9°). The patients had significantly reduced articular surfaces of the scaphoid bone (1.4 ± 0.2 cm²compared to 1.6 ± 0.2 cm²) and lunate (1.2 ± 0.4 cm²compared to 1.5 ± 0.3 cm²) and increased the thickness of the articular hole in the navicular (1.3 ± 0.1 mm compared with 1.2 ± 0.1 mm) and radial-moon (1.6 ± 0.2 mm compared with 1.3 ± 0.3 mm).

There is reduced mobility of Laceae and Triquetrum bones in Madelung deformity.

Four -dimensional imaging that examines the effect of surgical ligament release on wrist skin matics and subsequent wrist mobility can be used in future studies.

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These causes are not related to Vickers ligament. There is an association with Leri-Weill dyschondrosis. 26 At presentation, the most common primary complaints are diffuse pain or concern about the cosmetic appearance of the distal elbow markings and may be bilateral.

Evaluation of the role of combined computed tomography (CT), arteriography (CTA), phlebography and urographs in laparoscopic partial nephrectomy (LPN) with segmentation of the kidney artery.

Seventy-five patients underwent a partial nephrectomy with a segmented renal artery clamp. Three-dimensional (3D) CTA, CT venography and CT Urlym.

All procedures were successfully performed without conversion to the main clamp of the renal artery. The mean operating time was 82.6 minutes, and the mean time for the target arterial clamp was 20.3 minutes. Class I 1. Class II complications were 5.3% and 5.3%, respectively. In comparison to the actual orientation with CTA, the use of the combined 3D model has resulted in the change of the planned hilar approach to target excision in 18 cases (24%). The location of the tumor correlated with the modification of the planned if approach., and 37.5% of insidious tumors were treated with a modified approach (P= .001). Only 11.1% of anterior tumors and no posterior or superior tumors are subject to Hilar method modification when assessed with a combined 3D model. Tumor size and tumor growth pattern did not affect the distribution of approach modifications (S= 0,89 iP= 0,52).

The combined 3D model appears to facilitate the orientation of the target artery and the surgical disc. The combined model may change the surgical approach used for some lower pole tumors or kidney tumors compared to the approach suggested by conventional CTA.