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Original Article

Is Pronator Quadratus Affected In Volar Approach To Distal Radius Fractures?

Mahmut Tunçez, Hüseyin Tamer Ursavaş, Hülya Çetin Tunçez, Mesut Tahta.


Objective: One of the structures encountered in surgical incision in volar Henry approach to distal end of the radius is the pronator quadratus (PQ) muscle. It may be preferable to repair the PQ after the surgery on radius, but due to the structure of the muscle tissue, the success of repair and therefore repair indications are still controversial. Therefore, in this study, we aimed to evaluate the PQ muscle placement and functional conclusions of patients with radial distal end fractures treated with volar locking plate.
Methods:74 patients with closed distal radius fractures who underwent osteosynthesis with volar plate, are over 18 year were evaluated. Quick DASH, Stewart Scoring Board, AO classification, Frykman classification, thickness of the PQ muscle with USG, ranges of motion of wrist and grip strengths were recorded.
Results:In 26 patients with PQ repair and 48 without PQ repair; no significant difference was found in QDASH scores (p=0.954), grip strength (p=0.300), ranges of motion of wrist and Stewart scores. No statistically significant thickness difference was found in USG transverse (p=0.312) and longitudinal (p=0.137) measurements made in patients with or without repair. Loss of thickness compared to the intact side was found as 15.4% in all patients.
Conclusion:We found that PQ repair had no significant effect on range of motion of wrist, QDASH score or grip strength. We found an average 15.4% atrophy whether it was repaired or not. We believe that the portion of PQ removed from the radius does not affect the function of hand.

Key words: pronator quadratus, distal radius, wrist ultrasonography

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