The authors retrospectively studied the results of the Darrach and the Sauve-Kapandji procedures for the treatment of distal radio-ulnar joint (DRUJ) derangement following malunion of displaced, intraarticular fractures of the distal radius in patients under 50 years of age. The mean follow-up was > 1 year. The Darrach procedure (21 cases) and the Sauve-Kapandji procedure (12 cases) yielded comparable but unpredictable results with respect to both subjective (DASH scores) and objective (Mayo Modified Wrist Scores) criteria.
Multiple procedures have been described to treat DRUJ dysfunction in this setting. These include the Darrach procedure, hemiresection and interposition arthroplasty, ulnar head replacement, matched distal ulna resection, and the Sauve-Kapandji operation. Published results using these different techniques have varied. Lower demand patients seem to tolerate loss of the end of the ulna better than physiologically younger individuals with higher loading requirements. Future comparative studies would be advantageous in providing additional information on the surgical indications for each technique and the relative outcomes. Distal radioulnar joint dysfunction following Colles’ fracture is not rare and one must not neglect this joint when treating these injuries, especially in physiologically younger individuals.
J Hand Surg