DYNAMIC RADIOULNAR CONVERGENCE AFTER THE DARRACH PROCEDURE

We reviewed 23 patients who had had 25 Darrach procedures for traumati c or post-traumatic disorders of the wrist at a mean follow-up of 75.5 months (36 to 121), The mean age at the time of operation was 61.1 ye ars (34 to 82), All patients were reviewed in person, Assessment inclu ded a history, a questionnaire on patient satisfaction and a detailed physical examination, Standardised radiographs of both wrists were tak en with the patient's hands in a resting position and during maximal g rip, Convergence of the distal ulnar stump towards the distal radius d uring maximal grip (dynamic radio-ulnar convergence) was seen in 14 wr ists including five with actual contact (dynamic radio-ulnar impingeme nt), but this produced symptoms in only two cases, The presence of dyn amic radio-ulnar convergence did not correlate with grip strength, pin ch strength, range of movement or wrist score, but was associated with increased length of excision of the distal ulna, Nineteen of the 23 p atients were satisfied with the procedure, Dynamic radio-ulnar converg ence is common after the Darrach procedure, but is rarely symptomatic; resection of the distal ulna remains a reliable procedure in the olde r patient with pain and loss of movement, Excision of the lower end of the ulna should be restricted to the least required to restore full r otation.