Abstract
Forty-four patients underwent surgery for chronic ulnar-sided wrist disorders. Their diagnoses were malunion of distal radial fracture in 25 patients, ulnocarpal abutment syndrome in 11, and primary distal radioulnar joint (DRUJ) osteoarthrropathies in eight. The procedures performed included Darrach's procedure in three patients, ulnar shortening in 17, hemiresection interposition arthroplasty in six, and Sauvé-Kapandji's procedure in 18. Each case was assessed preoperatively and postoperatively using a modified Cooney's score. The overall result included 17 excellent outcomes, 12 good, 13 fair, and two poor. In order to select the best procedure for patients with disorders of the ulnar wrist joint, preoperative assessment of DRUJ congruity and stability is essential. In ulnocarpal disorders without DRUJ incongruity, ulnar shortening should be selected. In cases with DRUJ incongruity but stable, hemiresection interposition arthroplasty is indicated. In cases with an unstable, incongruous DRUJ, Sauvé-Kapandji's procedure is recommended. Darrach's procedure is indicated only in elderly, inactive patients.
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