The technical simplicity of the Darrach procedure may explain why it has been so popular. Excising the distal ulna, however, may have potentially undesired consequences to the biomechanics in two areas: the distal radioulnar and the ulno-carpal joints. These conjointly define the radio-ulno-carpal joint (RUCJ). The RUCJ is not a small and irrelevant articulation that can be removed without possibly paying a functional penalty. It is an important link of the antebrachial frame that provides stability to the distal forearm and the carpus. This article revisits the mechanisms by which some ligaments and muscles ensure that all forces about and within the RUCJ are dealt with efficiently.
Ananos D, Garcia-Elias M. Open surgery for chronic scapholunate injury. In: Del Pinal F (Ed.) Distal radius fractures and carpal instabilities. FESSH IFSSH 2019 Instructional Book. Stuttgart, Thieme, 2019: 220–6.
2.
ArimitsuSMoritomoHKitamuraT, et al.(2011) The stabilizing effect of the distal interosseous membrane on the distal radioulnar joint. J Bone Joint Surg93: 2022–30.
HagertEHagertCG (2010) Understanding stability of the distal radioulnar joint through an understanding of its anatomy. Hand Clin26: 459–66.
5.
HolmesMWRKeirPJ (2014) Muscle contributions to elbow joint rotational stiffness in preparation for sudden external arm perturbations. J Appl Biomech30: 282–9.
6.
KakarSGarcia-EliasM (2016) The four leave clover treatment agorithm: a practical approach to manage disorder of the distal radioulnar joint. J Hand Surg Am41: 551–64.
7.
KiharaHShortWHWernerFWFortinoMDPalmerAK (1995) The stabilizing mechanism of the distal radioulnar joint during pronation and supination. J Hand Surg Am20: 930–6.
8.
MarkolfKLLameyDYangSMealsRHotchkissR (1998) Radioulnar load-sharing in the forearm. A study in cadavera. J Bone Joint Surg Am80: 879–88.
9.
PalmerAKWernerFW (1981) The triangular fibrocartilage complex of the wrist-anatomy and function. J Hand Surg Am6: 153–62.
10.
PalmerAKWernerFW (1984) Biomechanics of the distal radioulnar joint. Clin Orthop187: 26–35.
11.
ReinSEsplugasMGarcia-EliasM, et al.(2020) Immunofluorescence analysis of sensory nerve endings in the interosseous membrane of the forearm. J Anat236: 906–15.
