Three-dimensional progressive correction of Madelung deformity using the Ilizarov technique in patients aged ≥12 years: a retrospective study

Background Madelung deformity is a rare developmental wrist abnormality that often leads to joint pain and limited mobility. Traditional surgical methods typically struggle to simultaneously correct the abnormal bone angle and the associated bone shortening. This study assesses the efficacy and safety of the Ilizarov progressive three-dimensional orthopedic technique in treating Madelung deformity in patients aged 12 years or older. Methods We performed a retrospective analysis of data from 19 patients aged 12 years or older with Madelung deformity who were treated with the Ilizarov technique between 2020 and 2024. This single-center study was a retrospective case series (Level IV evidence). During the surgery, we executed an osteotomy on the radius and installed an adjustable external fixator. Postoperatively, we made gradual adjustments to correct the wrist deformity angle and simultaneously lengthen the bone. We evaluated surgical outcomes with imaging measurements and functional scores and recorded all complications. Results The study observed a significant improvement in both the angular deformity of the wrist and bone length among all patients. Additionally, there was a notable increase in the range of motion in the wrist joint and hand grip strength. Postoperative functional scores were excellent or good in 89.5% of cases. Only a few patients experienced mild pin tract infections, and no serious complications were reported. Conclusions The Ilizarov technique successfully corrected angular and length abnormalities associated with Madelung deformity, significantly enhancing wrist function. It proved to be safe and can be recommended as a treatment option for individuals with moderate to severe deformity, particularly those with closing or closed physes. Further long-term follow-up studies are needed to confirm its lasting effects.