The Darrach procedure defended: technique redefined and long-term follow-up.

Thirty-three patients with pain and decreased range of motion after traumatic derangement of the distal radioulnar and ulna-carpal joint were treated with a modified Darrach distal ulnar resection. Their ages ranged from 22 to 75 years (average, 50 years). Twenty-seven patients had Colles' or other distal radius fractures. Seven patients had ulnar resection for treatment of distal ulnar-carpal derangement. Follow-up averaged 54.4 months. The patients showed an average increase in extension of 58% and flexion increased by 40% (p less than 0.01). Pronation increased by 40% and supination increased by 60% (p less than 0.01). Average grip strength increased by 38% (p less than 0.05). Ninety-one percent good or excellent results were achieved with this procedure. The Darrach resection can predictably provide pain relief while improving strength and motion when attention is paid to minimal bony resection and meticulous soft tissue reconstruction.