RESECTION OF THE DISTAL END OF THE ULNA (DARRACH OPERATION)

An End-Result Study of Twenty-Four Cases

¹ Hospital for Special Surgery, New York City

From a review of this series of cases, it is evident that the best results were obtained in those patients who had had a minimal amount of bone removed or in those in whom the process of bone regeneration was especially active.

It might therefore be suggested (Fig. 6):

1. That emphasis be placed, not on the amount of ulna to be resected, but rather on the amount of ulna to be preserved. (Only that amount of bone should be removed which would allow the distal portion of the ulna to lie adjacent to the sigmoid notch of the radius. Preoperative roentgenograms should be studied to determine the proper amount);

2. That excision of the distal portion of the ulna should be done subperiosteally to encourage anatomical and physiological regeneration of the distal end of the ulna;

3. That the ulnar styloid process, with the ulnar collateral ligament attached, be left in situ.

The purpose of these measures would be to effect, as much as possible, the restoration of the normal anatomy of the distal radio-ulnar articulation.

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