Sparing the pronator quadratus for volar plating of distal radius fractures: a comparative study of two methods

Abstract

Objectives The objective of this study was to compare the results of two methods for sparing the pronator quadratus in volar plating of distal radius fractures. Methods A total of 110 patients were randomized to volar plating with sparing of the pronator quadratus either by a transverse incision along the distal border of the pronator quadratus (Group A, 55 people) or by the brachioradialis splitting method (Group B, 55 people). The operative and radiation time, range of motion, grip strength, Disabilities of the Arm, Shoulder, and Hand (DASH) scores, Visual Analog Scale (VAS) scores, and complications were recorded. Results There were no significant differences in the mean operative time, radiation time, mean bone union time, or total complication rate between the groups. We found no significant differences in range of motion, grip strength, VAS scores, and DASH scores at any of the study intervals between the groups. Although neurapraxia of the superficial branch of the radial nerve was more common in Group B than in Group A (6.7% vs. 0%), the difference was not significant. Conclusions Both methods were efficient approaches for sparing the pronator quadratus and had similar clinical outcomes, but they had different indications.

Do We Really Need to Repair the Pronator Quadratus in Volar Plating of Distal Radius Fracture？A Protocol for Systematic Review and Meta Analysis

“…After 2 days, postoperative X-ray photography will be performed to check the fracture reduction and internal xation [7,12] .…”

“…Distal radius fractures are responsible for high incidence worldwide, mostly due to the anatomy of distal radius,which is located between cortical and cancellous bone [1,2] .According to relevant research statistics, distal radius fractures are the most common upper limb fractures [3] . Currently, open reduction and volar plate internal xation of distal radius fractures is the best treatment option [4][5][6] .To better place on the deep surface of the PQ muscle, it is necessary to be dissected during the operation [7][8][9] .However, whether to repair the PQ muscle remains controversial.83% (608/753) members of the American Society of Hand Surgery of a previous study recommended that they tried to repair the PQ muscle [10] . The main reason is that it is more bene cial to the recovery of the PQ strength, the stability of the distal radioulnar joint, and avoid the damage caused by the long-term friction between the volar exor tendon and the plate.…”

“…The results of another study showed that repairing the PQ muscle can reduce the short-term pain of postoperative patients [14] . Many experiments have compared the effect of repairing and not repairing the PQ muscle on the postoperative e cacy of distal radius fractures [7,[12][13][14] . However, there is still a lack of high-quality systematic reviews.…”

Does pronator quadratus repair affect functional outcome following volar plate fixation of distal radius fractures? A systematic review and meta-analysis

“…At the same time, they also believe that the tight suture of the PQ may lead to postoperative ischemic contracture of the wrist joint, thereby reducing the postoperative range of motion of the wrist joint (6). However, some clinicians believe that suturing the PQ can help patients restore more forearm pronation function after surgery and avoid longterm friction between the volar flexor tendon and the plate (7)(8)(9). At the same time, it can also make the inferior radioulnar joint more stable.…”