Madelung's Deformity

Madelung’s deformity is a deformity of the wrist where part of the distal radius does not develop properly, leading to subluxation (partial dislocation) of the wrist bones between the radius and ulna. The distal joint between the radius and ulna is dislocated, leading to a prominent bump from the head of the ulna. Madelung’s deformity is a Blount’s deformity of the wrist; there is a bowing of the radius. The condition was first described by German physician, Otto Madelung, in 1878.

Patient with Madelung's deformity. Note the prominent bump from the head of the ulna

 

Madelung’s deformity occurs most prominently in adolescent females who complain of pain and decreased wrist range of motion. It is thought that Madelung’s deformity is caused by mutations on the X-chromosome. Many cases of Madelung’s deformity are hereditary and some are related to mesomelic dysplasia. The condition manifests bilaterally (affecting both limbs) in 50% of cases.

Symptoms of madelung’s deformity do not begin until the patient begins adolescence (ages of 10-14). It is very rare for patients to present under 10 years of age. The mechanism that causes the deformity to develop in adolescence is a partial closure of the distal radial growth plate. This leads to the characteristic shortening of the radius and resultant dislocation of the wrist joint. Various factors have been identified to explain this development, and Madelung’s deformity has been divided into the following types:

  • Post-traumatic
    • Damage to the growth plate following injury
  • Dysplastic
  • Genetic
    • Genes on the X-chromosome have been linked to a hereditary form of Madelung's deformity
  • Idiopathic
    • Unknown or spontaneous origin

At the Paley Institute, we recommend surgical treatment of Madelung’s deformity for the alleviation of pain and to restore function to the wrist. 

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