Madelung Deformity Clinical Presentation

Updated: Jun 02, 2016
  • Author: Paul M Lamberti, MD; Chief Editor: Jeffrey D Thomson, MD  more...
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Presentation

History and Physical Examination

Symptoms of Madelung deformity (MD) usually begin during adolescence in girls aged 10-14 years; patients rarely present when younger than 8-9 years. Because MD is observed so rarely in males, it has been proposed that a true severe case of MD never occurs in males.

Patients experience increasing deformity and pain in the wrist with decreased range of motion. On physical examination, the hand is translated volarly to the long axis of the forearm. The ulna, being relatively unaffected, abuts the carpus and becomes prominent dorsally relative to the carpus and hand. Range of motion is decreased, with a limitation of supination, dorsiflexion, and radial deviation. Pronation and flexion usually are normal. (See the images below.)

Preoperative photograph of 17-year-old girl (patie Preoperative photograph of 17-year-old girl (patient C) with idiopathic Madelung deformity.
Preoperative photograph of 17-year-old girl (patie Preoperative photograph of 17-year-old girl (patient C) with idiopathic Madelung deformity.