[Resection of the ulnar head in post-traumatic wrist pain]

In a retrospective study, the effect of distal ulnar resection using the Darrach procedure was evaluated in 42 patients with post-traumatic distal radio-ulnar disability. Thirty women and 12 men, mean age 43 years were seen an average of seven years after the operation. In 57% of the cases the primary trauma was a Colles fracture. The main indication for operation was pain radiating from the distal radio-ulnar joint (83%), but seven patients were without substantial pain. 79% of the patients felt relief of pain after the operation, but 62% still suffered from occasional wrist pain. Twenty-six patients had a supination and a pronation of > or = 150 degrees postoperatively. Thirty-three patients had a dynamic handpower of > 60% of the opposite hand postoperatively. Ten patients stopped working or changed to less physically demanding jobs after the primary trauma. Three patients from this group could after the operation return to their primary physically demanding jobs. Radiographs showed no progress of radiocarpal osteoarthritis during the follow-up period. The Darrach procedure could relieve post-traumatic distal radioulnar pain conditions without adverse effect on radiocarpal function and alignment. Patients who only had mild pain symptoms preoperatively presented unsatisfactory postoperative results.