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Related Experiment Videos

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
PubMed
Summary

This study shows a modified Darrach procedure effectively improved grip strength and pain relief in patients with forearm rotation issues. Patients with Colles

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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.

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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.