Madelung's deformity by Dr Monir Green 1.pptx

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1. WELCOME TO THE MORNING SESSION CASE PRESENTATION Dr. Md. Mostafa Monir MS(Phase B) Green Unit 1

2. Particulars of the patient Name : Mitu Age : 12 years Address : Muhammadpur , Magura Registration No : 253112 Ward/Bed : Cas-4/41 Date of Admission : 22/02/23

3. Presenting Complaints Progressive deformity of the both wrist for 2 years Difficulty in movement of both wrist joint.

4. History of present illness According to the statement of the patient , she was reasonably well 02 years back. Then she noticed deformity in her both wrist joint which was gradually increasing. She also complaints of some difficulty in movement of both wrist joint. She gave no history of trauma. With this complaints she got admitted to NITOR for better management.

5. History of Past illness Nothing significant Family History No other family members have similar kind of problem

6. General examination Appearance : Anxious Body built : Average Co-o pe ration : Co-operative Decubitus : On choice Anaemia : Absent Jaundice : Absent Cyanosis : Absent Pulse :78 b/min

7. Locoregional Examination Look : Visible deformity at both wrist joint Ulnar deviation of both hand Prominent distal ulna Overlying skin condition is normal

8. Locoregional Examination Feel: Temp: Normal Tenderness : Absent Distal Neurovascular status: intact Grip strength: Normal Move: Palmar flexion: Rt : 80 Lt: 80 Dorsiflexion: Rt : 20 Lt: 2 Supination and pronation: Normal

9. Salient feature Mitu , 1 2 years of age female admitted to NITOR with complaints of progressive deformity of her both wrist joint for last 2 years . On general examination, vital parameters are within normal limits, and systemic examination reveals no abnormality. On locoregional examination, the patient has visible deformity of her both wrist joint, ulnar deviation of the hand, ulna is prominent and overlying skin condition is normal . With the above mentioned complaints and findings, she got admitted to NITOR for further management.

10. Radial tilt

11. Ulnar tilt

12. Lunate subsidence

13. Palmar displacement

14. Diagnosis Congenital Bilateral Madelung’s deformity of both wrist in a 12 years old girl

15. Unit plan Vicker’s Ligament release with radial osteotomy and ulnar shortening