Disease Description Madelung deformity is an excessive angulation of the distal radius to the radial and palmar sides due to impaired growth of the distal palmar and ulnar epiphyses, sometimes the entire radius can be involved. The involvement is usually bilateral and begins to become apparent in early adolescence. The distal ulna of the affected wrist protrudes dorsally, the distal radius develops a depressed appearance, the forearm is shorter than normal, and wrist mobility may be reduced. Mostly an autosomal dominant disorder, it can also be caused by trauma. Treatment and timing If the deformity is associated with pain, surgery is usually required. The vast majority of patients do not like the appearance of a depressed distal forearm and a dorsal protrusion of the distal ulna and require corrective treatment to improve the appearance. Surgery includes ligamentotomy combined with osteotomy, ulnar shortening osteotomy, radial sparing combined with wedge osteotomy, and radial osteotomy combined with distal ulnar osteotomy. Most patients are first seen in adolescence, when the limb has some growth potential and there is no pain or obvious deformity in the early stage. If the deformity progresses, epiphyseal release and ligamentous release should be performed. Risks and prognosis of surgery In most cases, surgery will reduce the symptoms of wrist pain and forearm deformity.