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  • This is caused by an asymmetric growth arrest of volar and ulnar aspect of distal radial physis, resulting in increased volar and ulnar tilt.
  • Several possible causes:

- An abnormal band between the radius and lunate called Vickers ligament.
- premature fusion ulnar half of distal radial epiphysis
- Associated with:

  1. Multiple epiphyseal dysplasia
  2. Ollier’s disease
  3. post traumatic
  4. post infective growth arrest
  • adolescence girls, often bilateral


  • + ulnar variance
  • Lunate subsidence
  • increased radial inclination
  • prominent ulna due to subluxation of radius (rather than an ulna problem)


  • release of Vickers ligament
  • excision of physeal bar and dermo-fat graft insertion
  • radial lengthening
  • correction residual deformity

m pic1.png

Pathological Vickers ligament in Madelung’s deformity (1). Release of physeal bar and Vickers ligament (2) and Restoration of radial growth (3)

[Image is courtesy of Paediatric Orthopaedics by Matthew Nixon Lulu publishing 2012]

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Madelung’s Deformity correction


  • osteochondromas of ulna inhibits ulna growth
  • radius grows normally, bows round ulna
  • rado-capitellar dislocation

Clinical features

  • ulnar deviation of hand
  • prominent radial head
  • loss of supination


  • debridement of ostoechondroma
  • restoration of ulnar length
  • span elbow to allow RH reduction

m pic 3 .png

Pseudo-Madelung’s deformity. Ulna growth arrest following ulna osteochondromas. Ulna distraction to lenghthen the ulna with or without excising the osteochondroma [Image is courtesy of Paediatric Orthopaedics by Matthew Nixon Lulu publishing 2012]