Madara and Itachi are both some of the strongest characters in Naruto history. Both of them are very skilled with the Sharingan and they have many lethal attacks. Itachi has shown us more hand to hand skills in the past, but Madara seems to be physically superior to Itachi. It would definitely be a very close fight between these two opponents, but I believe that Madara would be able to take the win. Madara wins.