Make an appointment (805) 370-6877

Treatment of Madelung’s Deformity

June 30th, 2016 | HandSurgeon Admin

Treatment of Madelung’s deformity in adults by ulna reduction osteotomy.

PubMed – NCBI

Bruno RJ1, Blank JE, Ruby LK, Cassidy C, Cohen G, Bergfield TG.

Author information

  • 1Department of Orthopaedic Surgery, New England Medical Center, Tufts University School of Medicine, Boston, MA 02111, USA.



Adult patients with Madelung’s deformity may present with ulnar-sided wrist pain. Treatment often involves addressing the distal radial deformity. If there is focal wrist pathology and a positive ulnar variance, however, then an isolated ulnar-shortening osteotomy may provide symptomatic relief in these patients. The purpose of this study was to report our results of ulnar-shortening osteotomy without radial osteotomy in adult patients with Madelung’s deformity.


From 1988 to 2001 9 wrists in 9 adult patients with Madelung’s deformity and ulnar-sided wrist pain underwent ulnar-shortening osteotomy. The distal radius abnormality was not addressed. All of the patients were women and the average age at the time of surgery was 34 years (range, 29-45 y). Two of the individuals were mesomelic dwarfs and the remaining 7 patients were otherwise normal. Surgery was performed after the patients failed at least 6 months of nonsurgical management.


All patients had improvement of their symptoms at an average follow-up evaluation of 42 months (range, 6-112 mo). All of the osteotomies united. One patient required replating for a delayed union. There were no infections and no ulnar carpal subluxation. Ulnar-positive variance correction averaged 4.4 mm. Postoperative range of motion and grip strength were equivalent to the contralateral wrist.


Ulnar-shortening osteotomy is a safe and reliable surgical procedure that can relieve ulnar-sided wrist pain in adult patients with symptomatic Madelung’s deformity and positive ulnar variance.