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A modified extensor carpi ulnaris tenodesis with the Darrach procedure
T M Tsai1, H Shimizu, P Adkins
1Christine M. Kleinert Institute for Hand and Micro Surgery, Lousiville, Ky 40202.
The Journal of Hand Surgery
|July 1, 1993
Summary
This study shows a modified Darrach procedure effectively improved grip strength and pain relief in patients with forearm rotation issues. Patients with Colles
Area of Science:
- Orthopedic Surgery
- Hand Surgery
- Reconstructive Surgery
Background:
- Distal radioulnar joint (DRUJ) pain and limited rotation significantly impact patient function.
- The Darrach procedure is a common treatment for DRUJ pathology, but modifications may improve outcomes.
Purpose of the Study:
- To evaluate the efficacy of a modified Darrach procedure using an extensor carpi ulnaris (ECU) tendon slip.
- To assess functional outcomes, including grip strength and pain relief, in patients undergoing this modified procedure.
Main Methods:
- Fourteen patients with DRUJ issues (Colles' fractures, rheumatoid arthritis, osteoarthritis) underwent the modified Darrach procedure.
- A distally based slip of the ECU tendon was incorporated into the procedure.
- Patients were grouped by diagnosis (rheumatoid arthritis vs. Colles'/osteoarthritis) for analysis.
Main Results:
- Significant improvements in grip strength were observed in both groups postoperatively.
- The Colles'/osteoarthritis group improved from 26% to 74% grip strength; the rheumatoid arthritis group improved from 67% to 144%.
- No dorsal distal ulnar instability was noted on radiographic examination, and patients reported satisfaction with pain relief and return to work.
Conclusions:
- The modified Darrach procedure with an ECU tendon slip is a safe and effective treatment for painful DRUJ conditions.
- This technique leads to substantial gains in grip strength and patient satisfaction, facilitating return to work.