Darrach Procedure — Wrist Darrach Procedure (Distal Ulna Resection)

University of Virginia Orthopaedic Surgery

Weight-Bearing

NWB surgical UE

Key Restrictions

No passive forearm rotation; limit forearm pronation to midrange until 6 weeks; no resistance strengthening until 8 weeks; cast until week 3-4; WHO in neutral until week 8; WHO at night until week 10-12; soft tissue repair stabilizes ulna from translation

Timeline & Phases

Phase 1 (0-2 wks): volar wrist or posterior long arm splint; Phase 2 (2-8 wks): cast until wk 3-4 then WHO neutral full time, wrist flex/ext midrange from wk 4, forearm rotation from full supination to midrange pronation; PROM from wk 8, resistive strengthening from wk 10; Phase 3 (8-12 wks): wean WHO during day, continue WHO at night until wk 10-12, progressive wrist/forearm strengthening, PROM

Notes

Average functional ROM post-Darrach: pronation/supination 85/78°, flexion/extension 41/45°, radial/ulnar deviation 14/19° (Grawe et al. 2012); soft tissue repair stabilizes ulna from translation; limit pronation to midrange until 6 weeks; long-term night orthosis as needed

Published

09/2024