International Journal of Research in Orthopaedics | March-April 2023 | Vol 9 | Issue 2 Page 432 International Journal of Research in Orthopaedics Agarwal A et al. Int J Res Orthop. 2023 Mar;9(2):432-434 http://www.ijoro.org Case Report Modified dual osteotomy for Madelung’s deformity Aditya Agarwal 1 , Rahul Patel 1 *, Mohit Jain 1 , Shubham Arora 1 , Paresh Golwala 1 , Srishty Agarwal 2 INTRODUCTION Madelung’s deformity of the wrist was first described by Otto Madelung in 1878 and includes a spectrum of deformities causing the shortening of one or both bones of the forearm. It is seen mainly in the age group of 8 to 14 years, more common in females (4:1), and is often bilateral. The exact etiology of this deformity is not known. However, Herry and Thorburn have divided it into four different groups: 1) Idiopathic or primary 2) secondary to trauma, infection or tumor 3) dysplastic conditions like Ollier’s disease 4) genetic conditions like turner syndrome. 1 Furthermore, typical Madelung’s deformity can be identified from others by the presence of the “Vickers” ligament, an abnormally short, volar, radioulnar ligament, which interferes with distal radioulnar growth leading to increased volar tilt and increased inclination of radial articulation surface. This positive ulnar variance makes painful wrist joint movement, which is the major cause of presentation. Many cases have been published of typical Madelung’s deformities, but very few have been published on Madelung’s like deformities. We have performed a dual osteotomy of the radius and ulna with periosteal preservation and fixation subsequently in a 9-year-old male child in a case of Madelung’s type of deformity, who presented to us with a complaint of pain and deformity in the left forearm. CASE REPORT A 9-year-old male child presented to our department with complaints of chronic pain and deformity of the left wrist and forearm, aggravated during activity. On further evaluation, the patient also had bony swelling on the ulnar aspect of his left wrist. He also had similar bony swelling arising on the medial aspect of the proximal tibia. There is no history of trauma or any relevant family history noted. Physical examination revealed ulnar deviation of the left hand with reduced grip strength. Extension/flexion of both wrists was about 65/80 degrees. Pronation and supination were 80/80 degrees. ABSTRACT Madelung’s deformity is one of the rare congenital deformities of the forearm and wrist, typically seen as positive ulnar variance and increased volar tilt due to the “Vickers” ligament. Different corrective surgical methods for this have been done in the literature. In this case of a 9-year-old Madelung’s like deformity, we have performed a modified dual osteotomy with periosteal preservation allowing natural articulation and bone to be modified, especially in a younger child. This article gives the surgical option to orthopedics for the future, especially in a younger child with severe deformity. This is a level V evidence-based therapeutic study. Keywords: Madelung’s deformity, Congenital hand deformity, Osteotomy, Newer modality 1 Department of Orthopedics, Sumandeep Vidhyapeeth, Vadodara, Gujarat, India 2 New civil hospital, Surat, Gujarat, India Received: 27 October 2022 Revised: 19 December 2022 Accepted: 17 January 2023 *Correspondence: Dr. Rahul Patel, E-mail: drrnportho@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: https://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20230476