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CC BY-NC-ND 4.0 · Revista Iberoamericana de Cirugía de la Mano 2021; 49(02): e140-e154
DOI: 10.1055/s-0041-1739452
DOI: 10.1055/s-0041-1739452
Artículo de Actualización
Deformidad de Madelung: opciones de diagnóstico y tratamiento
Article in several languages: English | español
Resumen
La deformidad de Madelung (DM) comprende un aumento de la inclinación volar y cubital de la faceta articular del radio distal, secundaria a una displasia fisaria idiopática. Tal cambio causa un acortamiento radial y la consecuente prominencia cubital distal, junto con dolor en la muñeca y pérdida de movimiento. La cirugía se convierte en una opción en pacientes con deformidad severa que no responden al tratamiento conservador.
Las técnicas quirúrgicas clásicas son problemáticas para los adultos, pues son específicas para niños y adolescentes, cuya fisis radial aún está abierta. Muy pocos artículos discuten el tratamiento de pacientes adultos; además, la mayoría se centra en la articulación radiocubital distal y, por tanto, no se acercan al origen de la patología.
Al analizar la tomografía computarizada con reconstrucción tridimensional, se observa una característica de la DM, la detención del crecimiento de las porciones volar y cubital del radio distal, lo que provoca la deformidad típica del radio distal que conduce a la falta de cobertura del hueso semilunar. Eso conduce a una subluxación palmar del hueso semilunar y la consiguiente inestabilidad radiocarpiana.
Decribimos en este artículo las posibilidades de tratamiento en distintas etapas de evolución, y resumimos las opiniones de los autores sobre la DM.
Palabras clave
deformidad de Madelung - displasia longitudinal - subluxación de muñeca - malformaciones congénitas de la mano - perspectiva históricaPublication History
Received: 20 July 2021
Accepted: 01 October 2021
Article published online:
13 December 2021
© 2021. SECMA Foundation. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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