Results of pronator quadratus repair in distal radius fractures to prevent tendon ruptures

Abstract

Background:Distal radius fractures are one of the the most common adult fractures encountered during the clinical practice of an orthopedic surgeon.12 Although several methods of treatment are suggested for these fractures, there are still controversies about the best treatment approach in the literature. Volar plating of distal radius fracture is a method of treatment which has become increasingly popular. One of the complications of this technique is flexor tendon rupture. The purpose of this study was to evaluate the protectiveness of complete repair of pronator quadratus muscle against flexor tendon rupture.Materials and Methods:From September 2010 to September 2012, a consecutive series of 157 patients who were younger than 60 years with unstable distal radius fractures were included in the study. A standard volar approach to the distal radius was carried out. The radial and distal ends of pronator quadratus muscle were meticulously elevated from the radius and after volar plate fixation of the fracture, pronator quadratus muscle was restored to its normal insertion. We achieved full coverage of the plate with this muscle and followed the patients postoperatively.Results:A total of 135 patients were studied. The mean age of patients was 34 ± 10 years (range 20-60 years). One 55-year-old diabetic female patient with flexor tendon rupture was identified. The flexor pollicis longus tendon had ruptured 16 months after surgery.Conclusions:Pronator quadratus repair should be done in distal radius fracture to protect flexor tendons.

Intrarater and Interrater Reliability of the Soong Classification for Distal Radius Volar Locking Plate Placement

“…Plates that were directly on or distal to the volar rim were given a grade 2. Since the grading scale was published in 2011, it has been referenced in several studies, 5,[9][10][11][12][13][14] The purpose of this study was to analyze the intrarater and interrater reliability of the Soong classification for volar locking plate placement on a consecutive series of radiographs by surgeons of varying levels of experience. Our hypothesis was that the classification would be reliable.…”

Analysis of Upper Limb Movement Range and Global Grip Strength After Surgical Treatment of AO Type C Distal Radius Fractures Using LCP Plates and K-wires

“…In the present study, we encountered difficulties with restoring continuity of the quadrate pronator muscle, which is damaged in Henry's appro ach, and covering the plate implant. Other sur geons have described similar experiences as they analysed the necessity, type of treatment and function of the above muscle [15,16].…”

“…W ma te ria le wła snym spo ty ka liśmy się z trud no ścia mi przy wró ce nia cią gło ści mię -śnia na wrot ne go czwo ro bocz ne go uszka dza ne go w dostę pie Hen re go i po kry cia im plan tu płyt ko we go. In ni chi rur dzy ma ją po dob ne do świad cze nia do ko nu jąc ana li zy ko niecz no ści, spo so bu za opa trze nia i funk cji po wy ższe go mię śnia [15,16].…”

Impact of Design on Force between Flexor Tendons and Distal Radius Volar Plates

“…Indeed, we demonstrate that contact pressures exist even without plates, which suggest that it may not just be the contact pressure but also the material of the plate that contributes to tendon injury. This raises the hypothesis that, while no clinical studies have demonstrated a benefit of PQ repair over the plate, 24 there may be an advantage in covering plates to prevent the flexor tendons from contacting metal. Titanium and titanium alloys in particular have been shown to be irritating to tendons.…”