Surgical Skills Videos

Volar Dome Osteotomy of the Distal Radius for Madelung’s Deformity - Standard (Feat. Dr. Goldfarb) Clone


Created By:  Charles Goldfarb, Andrew Yee

Published: 2019

Duration: 10:03



Madelung’s deformity consists of anterior-ulnar bowing of the radius and a dorsally prominent ulnar head. This deformity is diagnosed in early adolescence when the prominence of the distal ulna and/or nonspecific wrist pain leads to a patient seeking an orthopedic opinion. Several operative techniques have been proposed for the painful or aesthetically unacceptable deformity. Vickers drew attention to an abnormal ligament (Vickers ligament) of the volar-ulna aspect of the radiocarpal joint. He subsequently reported success with the volar release of this ligament and physiolysis for Madelung’s deformity in early adolescence. The procedure has evolved to include a dome-shaped distal radius osteotomy to allow a 3D repositioning of the bone. Indications for correction of Madelung’s deformity include a painful wrist not responsive to conservative management and/or significant aesthetic deformity. In this case, a 17-year-old female presented with bilateral Madelung’s deformity with primarily central right wrist pain for several years and worsening over the last few months. Corrective volar dome osteotomy of the distal radius was elected following failed conservative management.