Department of hand surgery & Microsurgery.

Distal Radio Ulnar Joint

What is DRUJ ?

DRUJ is the abbreviation for Distal Radio Ulnar Joint (DRUJ). The two forearm bones radius and ulna are held by ligaments at the wrist. This articulation is known as distal radio ulnar joint ( DRUJ).

How is DRUJ injured ?

DRUJ injuries can occur by trauma or by diseases which can thin and rupture the ligaments Eg: Rheumatoid arthritis. Another wrist ligament which can be commonly injured is TFCC.


Ligament injuries are diagnosed by examining the wrist . Diagnosis is confirmed by x-ray and MRI.


Ligament injuries can be partial or complete. Partial injuries are often managed successfully by plaster, activity modifications and physiotherapy.
Complete DRUJ or TFCC injuries will require surgery.
TFCC repairs are often done through wrist arthroscopy.
Chronic DRUJ or TFCC injuries often require ligament reconstruction.
Sometimes chronic DRUJ injuries may progress to arthritis. They may not be amenable for reconstruction. They are often advised on activity modifications and physiotherapy. Salvage surgeries are suggested when response to activity modifications and physiotherapy are not effective.

Commonly performed salvage surgeries are

  • Bower’s hemiresection - interposition arthroplasty
  • Sauve - Kapandji procedure
  • Distal ulna resection ( Darrach’s procedure )