Madelung's deformity

(Otto Wilhelm Madelung, 18461926, German surgeon), a bowing of the distal end of the radius. Most commonly bowing of the radius occurs in a volar direction while the ulna continues to grow in a straight fashion, resulting in a radius that is shorter than the ulna. A decrease in the carpal angle is commonly present (Fig.1). Other radiographic alterations in Madelung's deformity include abnormalities of the radius, ulna and carpal bones

In the radius, dorsal and ulnar curvature, decreased length, triangularization of the distal radial epiphysis with unequal growth of the epiphysis, premature fusion of the medial half of the radial epiphysis, a localized area of lucency along the ulnar border of the radius, osteophytosis along the inferior ulnar portion of the radius, and ulnar and volar angulation of the distal radial articular surface may occur. In the ulna, dorsal subluxation, enlargement and distortion of the ulnar head, and changes in length are noted. Carpal abnormalities include wedging of the carpus between the deformed radius and protruding ulna, triangular configuration with the lunate at the apex, and arched curvature in the lateral projection.

A mesomelic variety of dwarfism known as dyschondrosteosis is associated with Madelung's deformity, although the nature of the relationship between the two is debated.

DR/RB