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A 13-years old left-handed Fars female, pre-menarche, presented with wrist mechanical pain and supination and extension limitation of her right forearm lasting for more than 1 year. Physical examination revealed ulnar head prominency, volar tilting of the carpus and hand, and 13 and 25 degree tender limitation of extension and supination of the wrist, respectively. Blood cell count and the blood chemistry analysis were normal. Her familiar history was positive for grandmother's deformity similar to her own, with being less symptomatic. The postero-anterior wrist X-rays (Figure 1) illustrated typical Madelung deformity changes on her both wrists which is characterized by shortening of radius bone , in comparison with the ulna, radially curved radius, a disparity of the distal radioulnar joint plus a triangular-shaped carpus. The lateral X-ray (Figure 2) showed major changes on the right wrist: dorsal

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