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Clinical features

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Typically, Madelung's Deformity presents at the age of 7-12 years with a progressive 'dinner fork' deformity of the wrist. There is a progressive palmar and ulnar bowing of the distal radius. Often, there is a spontaneous palmar subluxation of the wrist with the dorsal prominence of the ulna head. This can result in instability of the hand. The forearm is short. As a result of dorsal ulnar subluxation, rotatory motion at the wrist is painful. With dorso-ulnar distal radial growth abnormalities, the reverse may be seen: the carpus and hand displace dorsally and the ulnar head becomes visible and palpable on the palmar aspect of the wrist. In the intermediate state of 'chevron carpus', any radial or ulnar motion causes impingement and pain.


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