The ulnar head has often been surgically excised for a variety of clinical reasons, and numerous reports in the medical literature highlight that the outcomes of this procedure are remarkably favorable. Patients typically experience a significant restoration of their ability to perform pronation and supination, which are essential for daily activities. This surgical intervention alleviates discomfort and enhances functional mobility in the forearm, contributing to an overall improvement in quality of life. Unfortunately, this is not the primary function of the ulna head; it supports the distal radius and allows the forearm to bear weight. The ulna is the prominent forearm bone, with the radius being an appendix attached by a bicondylar joint through the annular ligament proximal and the triangular fibrocartilage ligaments distally. A brief history of the development of the total distal radio ulnar joint implant is discussed in this chapter.