MADELUNG STUDY
Inclusion ongoing
Background:
Madelung deformity of the wrist results from premature closure of the ulnar–volar aspect of the distal radial physis, leading to characteristic deformities of the distal radius, carpus, and distal ulna. The deformity progresses during growth and typically presents in early adolescence with wrist pain, reduced range of motion, and cosmetic concerns. Although Madelung deformity is associated with skeletal dysplasias such as Leri–Weill dyschondrosteosis and Turner syndrome, its prevalence and etiology remain poorly understood.
Rationale:
Management of Madelung deformity may be conservative or surgical; however, the lack of consensus regarding optimal diagnostic work-up and treatment strategies complicates clinical decision-making. To address these gaps, the departments of Orthopedic Surgery and Plastic Surgery have initiated a prospective cohort study in which patients with Madelung-type deformities are systematically evaluated, treated, and followed according to multidisciplinary consensus.
Objectives:
The primary objective is to evaluate the effect of conservative and surgical treatment on wrist function in patients with Madelung deformity, with the aim of improving evidence-based patient counseling. Secondary objectives include identifying the most informative diagnostic modalities for detection and surgical planning, developing a treatment algorithm, establishing a multidisciplinary center of expertise at Erasmus Medical Center, and providing structured patient education through group meetings and a dedicated website.
Methods:
This prospective cohort study includes children and adults diagnosed with Madelung deformity of the wrist. Patients will receive conservative or surgical treatment as determined by a multidisciplinary team, independent of study participation.
Outcomes:
The primary outcome is functional wrist outcome following treatment, assessed using patient-reported outcome measures and standardized clinical examinations.
