Good

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
1. Progressive deformity of the both wrist for 2 years
2. 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-operation : 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: 800 Lt: 800
• Dorsiflexion: Rt: 200 Lt: 200
• Supination and pronation: Normal

9. Salient feature
Mitu, 12 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.

12. Radial tilt

13. Ulnar tilt

14. Lunate subsidence

15. Palmar displacement

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

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