Case ReportNo Access

Dual Corrective Osteotomy of the Radius and Ulna for Mature Madelung Deformity Using CT-based 3D Simulation: A Case Report

Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan

E-mail Address: akirakodama@hiroshima-u.ac.jp

Correspondence to: Akira Kodama, Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan. Tel: +81-82-257-5233.

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Kaguna TANIMORO

Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan

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Shogo IWAGURO

Division of Dental Technician, Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, Japan

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, and

Nobuo ADACHI

Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan

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https://doi.org/10.1142/S2424835522720559Cited by:0 (Source: Crossref)

Abstract

We report a patient with mature Madelung deformity who underwent radial and ulnar corrective osteotomy using three-dimensional (3D) simulation. An osteotomy model was created using the computer-aided design (CAD) software based on the computed tomography (CT) data. After correcting the ulna, the osteotomy angle of the radius was determined using the location of the lunate as a landmark in the 3D plane created by the longitudinal axis of the corrected ulna. Consequently, the ulna was flexed 3° and shortened by 5 mm, and the radius was extended at 36° and ulna deviated at 25° by open wedge osteotomy. The radial inclinations, volar tilt and ulnar variance were 25°, 45° and 5 mm preoperatively, and improved to 22°, 10° and 0 mm after surgery. At the 18-month follow-up, the patient reported no pain even during sports activity. The preoperative 3D simulation enabled precise preoperative planning and accurate correction of the Madelung deformity.

Level of Evidence: Level V (Therapeutic)

Keywords:

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