Despite technologic advancements including arthrography, arthroscopy, and magnetic resonance imaging, pain in the distal radioulnar and ulnar carpal joints continues to baffle clinicians. Before the wide use of these diagnostic tests, the authors based their diagnosis of distal ulnar carpal joint derangement on the physical examination, history, and plain film roentgenographs. For eight patients who did not respond to conservative measures, a limited Darrach procedure was performed with highly satisfactory results. The specific technical aspects of this procedure are described. The postoperative results of the patients are presented with one to eight years of follow-up evaluation.