Episode 16: Managing DRUJ Arthritis from Workup to Operative Treatment with Marc Richard, MD

In this episode of the ASSH Handthology Podcast, host Sanjeev Kakar, MD, is joined by Mark Richard, MD, of Duke University, to discuss the evaluation and management of distal radioulnar joint (DRUJ) arthritis. Dr. Richard shares his approach to distinguishing DRUJ arthritis from other causes of ulnar-sided wrist pain, including key historical factors, physical exam findings, and his imaging workup.The conversation covers his surgical decision-making framework — centered on arthritis etiology and the presence or absence of instability — and how factors such as patient age, demand level, and ulnocarpal translocation influence his choice of procedure.Dr. Richard also offers detailed technical pearls on performing the Darrach procedure, including the importance of minimal resection and soft tissue sleeve preservation, as well as his approach to the Sauvé-Kapandji procedure for higher-demand patients. The episode closes with a discussion on managing instability, convergence, and the nuances of preoperative planning.The ASSH Handthology Podcast is a curated podcast for physicians and health care providers interested in hand surgery. Each episode will cover key topics related to the field of hand surgery including surgical techniques and treatment options, non-surgical treatment techniques and options, different hand, wrist, shoulder, and upper extremity conditions, and more.Learn more about Handthology, your go-to resource for comprehensive knowledge on hand, wrist, shoulder, and upper extremity surgery, by the ASSH: https://handthology.assh.org/Listen to other Handthology Podcast episodes: https://www.assh.org/hande/s/handthology-podcastLearn more about the American Society for Surgery of the Hand (ASSH): https://www.assh.org/s/