Prospective Evaluation of Pronator Quadratus Repair Following Volar Plate Fixation of Distal Radius Fractures

• Published in: The Journal of hand surgery (American ed.) Vol. 38; no. 9; pp. 1678 - 1684
• Main Authors: Tosti, Rick, MD, Ilyas, Asif M., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2013
• Subjects: Adult; Aged; Aged, 80 and over; Bone Plates; Distal radius; Double-Blind Method; Female; fracture; Fracture Fixation, Internal - methods; Fracture Fixation, Internal - rehabilitation; Hand Strength; Humans; Male; Middle Aged; Muscle, Skeletal - surgery; Orthopedics; outcome; Pain Measurement; Palmar Plate; Postoperative Care; Postoperative Complications - epidemiology; pronator quadratus; Prospective Studies; Radius Fractures - surgery; Range of Motion, Articular; Reoperation; Tendinopathy - epidemiology; volar plate; Distal radius; volar plate; pronator quadratus; outcome; fracture
• ISSN: 0363-5023; 1531-6564
• DOI: 10.1016/j.jhsa.2013.06.006

Purpose To evaluate the efficacy of pronator quadratus (PQ) repair after volar plating of distal radius fractures. Methods All consecutive distal radius fractures treated operatively with a volar plate during a 1-year period were assigned to receive a repair of the PQ versus no repair. Surgical exposure, reduction, and postoperative rehabilitation were equivalent in both groups. Clinical outcomes with a minimum follow-up of 12 months were assessed via range of motion; grip strength; Disabilities of the Arm, Shoulder, and Hand (DASH) scores; and visual analog scale (VAS) scores. Results A total of 60 consecutive distal radius fractures were treated operatively with a locking volar plate. Full follow-up data were available for 33 patients in the PQ repair group and 24 patients in the control group. At 12 months, the mean DASH score was 8 for the repair group and 5 for the control group. Range of motion at the wrist, grip strength, and VAS scores were also not significantly different between groups. In addition, we found no significant differences in any of the parameters at the 2-, 6-, or 12-week intervals, although we observed greater grip strength and wrist flexion in the repair group at 6 weeks. Reoperation was required for 4 patients in the repair group and 1 in the control group. Conclusions Pronator quadratus repair after volar plating of a distal radius fractures did not significantly improve postoperative range of motion, grip strength, or DASH and VAS scores at 1 year. The rates of reoperation between groups were not significantly different. Type of study/level of evidence Therapeutic II.