OBJECTIVE To evaluate the clinical results of Darrach’s procedure and Sauve-Kapandji’s procedure in the treatment of old derangement of distal radioulnar joint. METHODS Twenty-three patients with old derangement of distal radioular joint were divided into two groups, in which 11 patients received resection of distal end of ulna by Darrach’s procedure and 12 patients received pseudoarthrosis operation of the distal ulna by Sauve-Kapandji’s procedure. RESULTS Fifty-six months after Darrach’s procedure, complete relief of pain was obtained in 6 cases (P lt; 0.01), the flexion-extension movement improved from 104 degrees to 125 degrees (P lt; 0.01), rotation movement of the forearm improved from 106 degrees to 128 degrees (P lt; 0.01) and grippig strength improved from 17 kg to 28 kg (P lt; 0.01). Fifty-five months after Sauve-Kapandji’s procedure, complete relief of pain was obtained in 9 cases (P lt; 0.01), the movement flexion-extension improved from 108 degrees to 126 degrees (P lt; 0.01), rotation movement of the forearm improved from 101 degrees to 135 degrees (P lt; 0.01) and grippig strength improved from 17 kg to 35 kg (P lt; 0.01). CONCLUSION 1. The two operation showed no difference in relief of the wrist pain, improvement of the movement of the wrist and that of the forearm; 2. Sauve-Kapandji’s procedure was superior to Darrach’s procedure in increasing gripping strength; and 3. So the Sauve-Kapandji’s procedure was superior to Darrach’s procedure, especially in the long-term result, in the treatment of old derangement of the distal radioulnar joint.