Clinical outcome and evaluation of patients with distal end radius fractures operated with volar plate and pronator quadratus repair versus no repair

Abstract

Introduction: Dista l radi us fracture is the commonest fracture of upper extremity that we found during emergency or during orthopaedic practice, Now a days volar plating is more commonly perfomed surgery for the same. During this type of surgical exposure pronator quadrtus muscle is vital structure to come across and for this separation of muscle from radius must be done but after plate placement there is controversy regarding the repair of muscle is there. Repair of pronator quadratus muscle after plate fixation will protect volar flexo r tendon by covering the implant and also helpfull in pronation. Conversely if tight closure done its lead to ischemic contracture and its lead to limited wrist supination and pronation. Materials and Methods: This study was conducted on 30 patients having distal radius fractures operated with volar plating done by trained orthopaedic surgeon at our hospital in B. J. medical college, Civil hospital Ahmedabad between january 2017 and January 2019. The mean follow- up time was approximately 24 months. A standard volar approach was used and PQ muscle was separted from radius side and repaired after fracture fixation and were followed up post operatively. Result: Repair of pronator quadratus after volar radius plate fixation is depends on surgeon choice, here we have compaired our result with erlier study to evaluate the benefits, outcome and prognosis of patients post-operatively. Conclusion: After pronator quadratus repair pain reduced in early postoperative period but pronation strength in early post- operative rehabilitation period could not be confirmed, And both the patients give satisfactory and almost similar results with full range of movements and early mobilization. We recommended to repair PQ muscle to protect flexor tendons. Keywords: Distal radius fracture, Volar plate, Pronator quadratus, Radius, Ellis plating, Volar barton’s fracture, Buttress plate.