PURPOSE OF REVIEW: Distal radioulnar joint end-stage arthritis has historically been treated with resection of the distal ulna (the Darrach procedure). Failure following this procedure remains a difficult problem to manage. Numerous procedures have been described for salvage of a failed Darrach procedure with variable results and reproducibility in the literature. The purpose of this review is to explore the most recently described procedures, as well as those used historically for the treatment of failed distal ulna resection. RECENT FINDINGS: Recently newer endoprostheses and allograft reconstruction have been advocated for salvage treatment of failed distal ulna resection. These innovative techniques offer early promise; however, previously described distal ulnar stabilization procedures via tenodesis remain popular. SUMMARY: Current reconstruction options for failed Darrach procedure include distal ulnar stabilization via various tenodesis techniques, allograft reconstruction, and endoprosthesis. Although early results of newer techniques for salvage are encouraging, there is still insufficient evidence to determine long-term results.
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