The Impact of Physiotherapy Intervention of Madelung Deformity: A Case Study

Abstract

Introduction: Madelung deformity is a congenital wrist disorder caused by premature distal radial growth arrest, leading to volar subluxation. Physiotherapy supports pain reduction, protects healing, and gradually restores wrist mobility and strength. Objective: To evaluate the effectiveness of pre-operative physiotherapy in reducing pain and symptoms, improving wrist range of motion, and enhancing functional ability and overall quality of life. Case summary: Himel, a 17-year-old male student from Sirajganj, presents with a 3-month history of moderate, aching pain in both wrist joints following trauma. The pain (VAS 7/10) is constant and limits daily functional activities, with occasional paresthesia. Symptoms worsen with gripping and weight lifting and improve with rest. The condition has progressively worsened since onset, with only mild relief from painkillers, significantly affecting hand movement and overall function. Discussion: Physical examination revealed previously unrecognized bilateral Madelung deformity without symptoms. Conservative management, including wrist range-of-motion exercises, was initiated for six weeks and extended after improvement. Treatment should be individualized based on age, skeletal maturity, deformity severity, symptoms, and etiology. The main goals are preserving function, improving appearance, and protecting joint health. Mild cases are effectively managed with physiotherapy, splinting, pain control, and activity modification. Conclusion: Madelung deformity is a rare congenital wrist disorder caused by premature distal radial growth arrest, leading to volar subluxation, deformity, and limited motion. Often bilateral and more common in females, management includes supportive physiotherapy and structured post-surgical rehabilitation to improve function.