Darrach ECU FCU Tenodesis

A Darrach procedure (Removing the head of the distal ulna) is an effective procedure for treatment of distal radio-ulnar joint problems such as arthritis and other conditions causing ulnar sided wrist pain with ulnar impingement type symptoms. A criticism for the procedure is possible distal wrist instability which can be prevented by stabilizing the distal ulna with a portion of the extensor carpi ulnaris and flexor carpi ulnaris in those patients that may have a greater load on the hand post-operatively.

Distal head of the ulna visualized, prior to resection







Flexor carpi ulnaris being prepared to be split so that part can be passed through a drill hole in the distal remaining ulna for stabilization.






The head of the distal ulna resected.







A strip of flexor carpi ulnaris has been elevated from the tendon ready to be passed through a drill hole in the distal ulna. Similarly a strip of the extensor carpi ulnaris will be harvested and passed through the hole in the opposite direction and both secured so the distal ulna will be stabilized by a tenodesis of these two tendons.