Ultrasonographic evaluation of the distance between the flexor pollicis longus tendon and volar prominence of the plate as a function of volar plate positioning and pronator quadratus repair — A cadaver study

Goorens, Chul Ki; Royen, Kjell Van; Grijseels, S.; Provyn, Steven; Mey, Johan De; Scheerlinck, Thierry; Goubau, Jean

doi:10.1016/j.hansur.2017.12.008

Cited by 20 publications

(15 citation statements)

References 17 publications

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“…28,41 The following eight publications were cadaveric studies: two focusing on the anatomy of the distal radius, 27,36 two analyzing the fit of volar plates, 23,40 and four studies evaluating the relation between volar plate and tendons. 18,30,38,42 Sixteen of the included publications were performed in a clinical setting. Four of these were case series describing tendon injury.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…In general, after comparing all descriptions, "the watershed line" could be divided into the following categories: (1) interpretations that are based on soft tissue landmarks 22,[30][31][32][33] and (2) interpretations using bony landmarks as the main anatomic reference. 11,17,[19][20][21]23,24,[26][27][28][34][35][36][37][38][39][40][41] Within these two categories, we found eight different interpretations of the term "watershed line."…”

Section: Study Characteristicsmentioning

confidence: 99%

“…11,17,[19][20][21]23,24,[26][27][28][34][35][36][37][38][39][40][41] Within these two categories, we found eight different interpretations of the term "watershed line." Two descriptions made use of soft tissue landmarks which were (7) "the distal border of the pronator quadratus" [30][31][32][33] and A theoretical line marking the most volar aspect of the distal radius 11,20,34,35 2…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Colors correspond to characterizations in ►Table 1. The most proximal landmark used to characterize the watershed line was "the distal border of the pronator quadratus" [30][31][32][33] (line 7) and the most distal was "the most distal edge of the epiphysis" 28 (line 3).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Three descriptions did not fall under one of these subgroups, either because they were contradictive in itself or failed to present any landmark 42,45,46 (►Appendix 2). The most proximal interpretation of the term "watershed line" was "the distal border of the pronator quad-ratus" [30][31][32][33] and the most distal interpretation was "the most distal edge of the epiphysis" 28 (►Fig. 2).…”

Section: Study Characteristicsmentioning

confidence: 99%

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Interpretations of the Term “Watershed Line” Used as Reference for Volar Plating

et al. 2019

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Objective The objective of this systematic review is to provide an overview of all interpretations of the definition of the watershed line used in literature. Methods The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines were followed for this review. A comprehensive search was performed for definitions of the watershed line given in literature. A total of 32 studies giving an explicit interpretation of the definition of the watershed line or anatomical reference for plate positioning in writing and/or imaging were included. Results In 32 studies, we found eight different landmarks used to refer to the watershed line or correct plate positioning. Five studies used two different soft tissue landmarks. Six different bony landmarks were described in 24 studies. These could further be subdivided into three anatomical interpretations, described in seven studies, in which the term “watershed line” is explained as a distinguishable anatomical line, and two surgical interpretations, described in 15 studies, which are purely reflecting the optimal location of the volar plate. One interpretation of the watershed line described in two studies combined both anatomical and surgical landmarks. Conclusion The (mis)interpretation of the definition of the term “watershed line” as described by Orbay is subject to the type of landmarks and purpose used: soft tissue or bony landmarks and an anatomical or a surgical purpose. A clear distinction can be made between interpretations using bony landmarks, as the true watershed line is defined and definitions using soft tissue landmarks, which might represent the reference points surgeons use in clinical practice.

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Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

See 3 more Smart Citations

Interpretations of the Term “Watershed Line” Used as Reference for Volar Plating

et al. 2019

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Ultrasound Evaluation of the Protector Role of the Pronator Quadratus Suture in Volar Plating

Walch

Erhard

Vogels

et al. 2019

J of Ultrasound Medicine

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The main complication of volar locking plates for distal radius fractures is flexor tendon rupture. The flexor pollicis longus (FPL) is the most commonly ruptured. Repair of the pronator quadratus (PQ) is one of the ways to prevent tendon rupture. The main purpose of this series was to evaluate the role of PQ repair after volar plating to prevent flexor tendon rupture using ultrasound (US). This work was a mono-operator prospective series of 20 consecutive patients with volar locking plates for distal radius fracture between September 2014 and May 2015. The PQ was repaired in all patients. A clinical, ultrasound, and perioperative evaluation of the flexor tendon was performed by this same surgeon. There was no flexor tendon rupture or tenosynovitis. There were no type A cases, which are characterized by contact between the plate and the FPL, and mostly type C cases, which are characterized by no contact between the plate and the FPL on US imaging. The suture of the PQ was sustainable over time when we removed the plate. Pronator quadratus repair is one of the ways to prevent flexor tendon rupture after volar plating. The outward-running suture is an effective technique for repairing the PQ. Ultrasound may be helpful during follow-up to detect asymptomatic flexor tendon irritation.

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Ultrasound of the Pronator Quadratus PQ

Brasseur

2022

Ultrasonography for the Upper Limb Surgeon

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Ultrasonographic evaluation of the distance between the flexor pollicis longus tendon and volar prominence of the plate as a function of volar plate positioning and pronator quadratus repair — A cadaver study

Cited by 20 publications

References 17 publications

Interpretations of the Term “Watershed Line” Used as Reference for Volar Plating

Interpretations of the Term “Watershed Line” Used as Reference for Volar Plating

Ultrasound Evaluation of the Protector Role of the Pronator Quadratus Suture in Volar Plating

Ultrasound of the Pronator Quadratus PQ

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