Due to abnormal growth, the end of the radius typically grows palmarly and radially (i.e. in the direction of the palm and of the thumb). Because the other bone of the forearm -- the ulna -- is not affected and continues to grow, the end of the ulna becomes quite prominent on the dorsum, or back, of the wrist.

Furthermore, there are some cases in which prior trauma or injury to the growth plate at the end of the radius may cause a deformity similar to Madelung's.

In patients with pain, functional limitations, or progressive deformity, surgical treatment may be recommended. In general, the goals of surgical treatment are to reposition and stabilize wrist to allow for painless function and prevention of recurrent deformity. The type of surgery is dependent upon the patient's age, degree of deformity, functional limitations, and general health.

Treatment options include releasing the soft-tissue or bony tethers on the radius ("physiolysis"), cutting and realigning the end of the radius bone ("corrective ostetomy"), ulnar shortening osteotomy , or even removing the prominent end of the ulna bone ("the Darrach procedure"). Furthermore, wrist arthroscopy may also be performed in some patients to evaluate and treat cartilage injury within the wrist joint.