Congenital Forearm Deformities: Characteristics, Diagnosis, and Management.

Congenital forearm and wrist deformities, including Madelung's deformity, congenital radial head dislocation, and proximal radioulnar synostosis, present reconstructive challenges for upper extremity surgeons. While etiologically distinct, these developmental anomalies disrupt forearm rotation, elbow stability, and aesthetic appearance. This review examines the natural histories and management strategies necessary to restore form and function in pediatric patients. Madelung's deformity, characterized by distal radial physeal growth arrest and a tethering Vickers ligament, requires corrective osteotomies to address progressive pain and deformity. Congenital radial head dislocation necessitates radiographic evaluation to distinguish it from acquired trauma and is managed conservatively. Proximal radioulnar synostosis causes functional restrictions requiring derotational osteotomies in symptomatic patients. Precise anatomical understanding and individualized clinical judgment are essential to restore joint kinematics.