Question: Hi, I’m wondering what you can tell me about the effectiveness of Darrach’s excision (resection of the distal end of the ulna) with ECU tendon transfer in patients in their 30’s? I’m not finding a lot online and what I do find mentions elderly patients. I’m 7 months post closed distal radial fracture. It was reduced non-surgically, but even after months of physical therapy I’m still in a fair amount of DRUJ pain and my supination and pronation are severely impaired even after the PT. My ortho is now recommending the Darrach’s procedure.
Dr. Foreman: If your ulna is somewhat prominent at the wrist due to some shortening of the radius following the fracture, then shortening the ulna to take pressure off the distal radio-ulnar joint makes sense. If you damaged the distal radio-ulnar joint at the same time as the fracture, then repair of the DRUJ makes more sense. Ulnar shortening – done appropriately and for the correct problem – typically provides good pain relief with near normal function.
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