Top

Archives of Orthopaedic and Trauma Surgery

Published in:

01-10-2018 | Handsurgery

Pronator quadratus repair with a part of the brachioradialis muscle insertion in volar plate fixation of distal radius fractures: a prospective randomised trial

Authors: Bernd Hohendorff, C. Knappwerth, J. Franke, L. P. Müller, C. Ries

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 10/2018

Abstract

Introduction

Stable pronator quadratus repair following volar plate fixation of distal radius fractures with complete plate coverage is difficult.

Materials and methods

This study compares a modified pronator quadratus repair technique involving the brachioradialis muscle insertion (test group) with a conventional radial incision through the muscle without pronator quadratus repair (standard group). This prospective randomised study included 16 patients in the test group and 12 in the standard group; all were available for clinical, radiographic and ultrasound examination at a mean follow-up of 15 months.

Results

Pronator quadratus repair was feasible in all test group patients, and complete coverage of the distal plate was achieved in 11. No differences in functional outcome were observed between the groups.

Conclusion

Pronator quadratus repair with a part of the brachioradialis muscle insertion is a reliable technique for coverage of a volar plate by slight distal transposition. In the repair of distal radius fractures, this may better protect the finger flexor tendons against irritation and/or rupture. That likelihood should now be studied.

Unglaub F, Langer MF, Hohendorff B, Müller LP, Unglaub JM, Hahn P, Krimmer H, Spies CK (2017) Distal radius fracture of the adult: diagnostics and therapy. Orthopäde 46:93–110CrossRefPubMed

Swigart CR, Baden MA, Bruegel VL, Dodds SD (2012) Assessment of pronator quadratus repair integrity following volar plate fixation for distal radius fractures: a prospective clinical cohort study. J Hand Surg Am 37:1868–1873CrossRefPubMed

Abe Y (2014) Plate presetting and arthroscopic reduction technique (PART) for treatment of distal radius fractures. Handchir Mikrochir Plast Chir 46:278–285PubMed

Dos Remedios C, Nebout J, Benlarbi H, Caremier E, Sam-Wing R (2009) Préservation du muscle carré pronateur dans les ostéosynthèses des fractures de l’extrémité distale du radius par plaque palmaire verrouillée. Technique chirurgicale. Chir Main 28:224–229CrossRefPubMed

Erhard L, Boufarah C, Elkholti M (2007) Réparation du pronator quadratus par surjet aller-retour dans la voie de Henry. Rev Chir Orthop Reparatrice Appar Mot 93:381–384CrossRefPubMed

Fan J, Chen K, Zhu H, Jiang B, Yuan F, Zhu X, Mei J, Yu G (2014) Effect of fixing distal radius fracture with volar locking volar plates while preserving pronator quadratus. Chin Med J (Engl) 127:2929–2933

Heidari N, Clement H, Kosuge D, Grechenig W, Tesch NP, Weinberg AM (2012) Is sparing the pronator quadratus muscle possible in volar plating of the distal radius? J Hand Surg Eur Vol 37:402–406CrossRefPubMed

Hershman SH, Immerman I, Bechtel C, Lekic N, Paksima N, Egol KA (2013) The effects of pronator quadratus repair on outcomes after volar plating of distal radius fractures. J Orthop Trauma 27:130–133CrossRefPubMed

Lo HY, Cheng HY (2014) Clinical study of the pronator quadratus muscle: anatomical features and feasibility of pronator-sparing surgery. BMC Musculoskelet Disord 15:136CrossRefPubMedPubMedCentral

10.

Rey PB, Rochet S, Loisel F, Obert L (2014) Technical note: how to spare the pronator quadratus during MIPO of distal radius fractures by using a mini-volar plate. Chir Main 33:95–99CrossRefPubMed

11.

Sen MK, Strauss N, Harvey EJ (2008) Minimally invasive plate osteosynthesis of distal radius fractures using a pronator sparing approach. Tech Hand Up Extrem Surg 12:2–6CrossRefPubMed

12.

Zenke Y, Sakai A, Oshige T, Moritani S, Fuse Y, Maehara T, Nakamura T (2011) Clinical results of volar locking plate for distal radius fractures: conventional versus minimally invasive plate osteosynthesis. J Orthop Trauma 25:425–431CrossRefPubMed

13.

Diwersi N, Babst R, Link BC (2016) Miniplates as augmentation implants in osteosynthesis of complex distal radius fractures. Oper Orthop Traumatol 28:402–406CrossRefPubMed

14.

Häberle S, Sandmann GH, Deiler S, Kraus TM, Fensky F, Torsiglieri T, Rondak IC, Biberthaler P, Stöckle U, Siebenlist S (2015) Pronator quadratus repair after volar plating of distal radius fractures or not? Results of a prospective randomized trial. Eur J Med Res 20:93CrossRefPubMedPubMedCentral

15.

Ries C, Maier J, Wegmann K, Zhang W, Hohendorff B, Skouras E, Müller LP, Burkhart KJ (2013) Anatomic relationship between the pronator quadratus and brachioradialis muscle insertion: implications for repair of the muscle after volar plate fixation of distal radius fractures. Z Orthop Unfall 151:272–277CrossRefPubMed

16.

Hohendorff B, Surberg D, Maier J, Burkhart KJ, Müller LP, Ries C (2015) Repair of the pronator quadratus muscle with a part of the brachioradialis muscle insertion. Handchir Mikrochir Plast Chir 47:149–154CrossRefPubMed

17.

Tang JB (2009) Re: Levels of experience of surgeons in clinical studies. J Hand Surg Eur Vol 34:137–138CrossRefPubMed

18.

Pillukat T, Fuhrmann R, Windolf J et al (2016) The volar locking plate for extension fractures of the distal radius. Oper Orthop Traumatol 28:47–63CrossRefPubMed

19.

Orbay JL, Touhami A (2006) Current concepts in volar fixed-angle fixation of unstable distal radius fractures. Clin Orthop Relat Res 445:58–67PubMed

20.

Soong M, Earp BE, Bishop G, Leung A, Blazar P (2011) Volar locking plate implant prominence and flexor tendon rupture. J Bone Jt Surg Am 93:328–335CrossRef

21.

Asadollahi S, Keith PP (2013) Flexor tendon injuries following plate fixation of distal radius fractures: a systematic review of the literature. J Orthop Traumatol 14:227–234CrossRefPubMedPubMedCentral

22.

Kitay A, Swanstrom M, Schreiber JJ, Carlson MG, Nguyen JT, Weiland AJ, Daluiski A (2013) Volar plate position and flexor tendon rupture following distal radius fracture fixation. J Hand Surg Am 38:1091–1096CrossRefPubMed

23.

Ahsan ZS, Yao J (2012) The importance of pronator quadratus repair in the treatment of distal radius fractures with volar plating. Hand (N Y) 7:276–280CrossRef

24.

Huang HK, Wang JP, Chang MC (2017) Repair of pronator quadratus with partial muscle split and distal transfer for volar plating of distal radius fractures. J Hand Surg Am 42:935.e1–935.e5CrossRef

25.

Ateschrang A, Stuby F, Werdin F, Schaller HE, Weise K, Albrechts D (2010) Flexor tendon irritations after locked plate fixation of the distal radius with the 3.5 mm T-plate: identification of risk factors. Z Orthop Unfall 148:319–325CrossRefPubMed

26.

Tosti R, Ilyas AM (2013) Prospective evaluation of pronator quadratus repair following volar plate fixation of distal radius fractures. J Hand Surg Am 38:1678–1684CrossRefPubMed

27.

Chirpaz-Cerbat JM, Ruatti S, Houillon C, Ionescu S (2011) Dorsally displaced distal radius fractures treated by fixed-angle volar plating: grip and pronosupination strength recovery. A prospective study. Orthop Traumatol Surg Res 97:465–470CrossRefPubMed

28.

Mulders MAM, Walenkamp MMJ, Bos FJME, Schep NWL, Goslings JC (2017) Repair of the pronator quadratus after volar plate fixation in distal radius fractures: a systematic review. Strateg Trauma Limb Reconstr 12:181–188CrossRef

29.

Nho JH, Gong HS, Song CH, Wi SM, Lee YH, Baek GH (2014) Examination of the pronator quadratus muscle during hardware removal procedures after volar plating for distal radius fractures. Clin Orthop Surg 6:267–272CrossRefPubMedPubMedCentral

30.

Sato K, Murakami K, Mimata Y, Doita M (2018) Incidence of tendon rupture following volar plate fixation of distal radius fractures: a survey of 2787 cases. J Orthop 15:236–238CrossRefPubMed

Title: Pronator quadratus repair with a part of the brachioradialis muscle insertion in volar plate fixation of distal radius fractures: a prospective randomised trial
Authors: Bernd Hohendorff
C. Knappwerth
J. Franke
L. P. Müller
C. Ries
Publication date: 01-10-2018
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 10/2018
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-018-2999-5

At a glance: The STEP trials

Springer Medicine

Pronator quadratus repair with a part of the brachioradialis muscle insertion in volar plate fixation of distal radius fractures: a prospective randomised trial

Abstract

Introduction

Materials and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 10/2018

Long-term survival of the cemented Müller CDH stem: a minimum follow-up of 10 years

The efficacy and safety of knotless barbed sutures in total joint arthroplasty: a meta-analysis of randomized-controlled trials

Comparison of combined posterior and anterior spondylodesis versus hybrid stabilization in unstable burst fractures at the thoracolumbar spine in patients between 60 and 70 years of age

Preoperative disinfection of foot and ankle: microbiological evaluation of two disinfection methods

Total hip arthroplasty following illicit drug abuse

Translation and validation of the Simplified Chinese version of International Knee Documentation Committee Subjective Knee Form