Madelung's Deformity - Pathogenesis

Pathogenesis

Madelung deformity of the wrist is caused by a growth disturbance in the inferior volar part of the epiphysial growth plate in the distal radius resulting in a volar placed slope of the fossa lunatum and fossa scaphoideum. This produces volar translation of the hand and wrist. The ulna continues growing straight resulting in a dorsally prominent distal ulna. It occurs predominantly in adolescent females who present with pain, decreased range of motion, and deformity. It often has a genetic etiology and is associated with mesomelic dwarfism and a mutation on the X chromosome. The deformity can be treated surgically by addressing the deforming bony and ligamentous lesions called "The Vickers Ligament". This is an abnormal ligament formed between the Lunate bone of the wrist and the radius and it’s found in 91% of cases of Madelung's Deformity.