Complex carpal malformation without a cause

Carpal dislocation is an uncommon event. We present a 4-year-old male child who had the clinical appearance of a Madelung's deformity; however, he failed to fulfill the radiological criteria for a Madelung's deformity. The carpal bones had not yet ossified making it difficult to arrive at a diagnosis using radiograph alone. Magnetic resonance imaging was diagnostic because of the ability to delineate the carpal cartilaginous ossification centers. Chronic wrist dislocation should be considered in the differential diagnosis of a long-standing wrist deformity that clinically resembles a Madelung's deformity in a young child. J Pediatr Orthop B 18:302-303.