Abstract
BackgroundThe purpose of the present study was to investigate the influence of the pronator quadratus (PQ) muscle repair following volar plate fixation of distal radius fractures with special regards to the forearm pronation strength. During the early recovery period of 3 months, an improvement of pronation strength and functional scorings was hypothesized for the PQ repair when compared to no repair.MethodsThe inclusion criteria were (1) men or women between 18 and 80 years, (2) isolated, closed fractures of the distal radius, (3) A2 to B2 types of fracture according to the AO fracture classification system, (4) primary volar locking plate osteosynthesis. Patients were randomized to group A = PQ repair and group B = no repair. Follow-up examinations after 6 and 12 weeks included bilateral isometric pronation strength measurement, range of motion, the QuickDASH and the Mayo-Wrist-Score, and a visual analog scale (VAS).Results60 patients (n = 31 in group A and n = 29 in group B) with an average age of 54 years (range 22–77 years) returned for both follow-up visits. The pronation strength measurements showed no significant differences between groups (PQ repair vs. no repair) neither at 6 weeks nor at 12 weeks. Additionally, no statistical significant differences were noted for ROM, QuickDASH-Score or Mayo-Wrist-Score. The VAS scoring revealed a significant decreased pain level after PQ repair at 6 weeks postoperatively (p = 0.017).ConclusionAn improved pronation strength after PQ repair in the early rehabilitation period could not be confirmed. However, the PQ repair might reduce pain in the early postoperative period.Trial registration number: NCT02595229 (ClinicalTrials.gov, registered 02 November 2015)
Highlights
The purpose of the present study was to investigate the influence of the pronator quadratus (PQ) mus‐ cle repair following volar plate fixation of distal radius fractures with special regards to the forearm pronation strength
Even though there are several studies evaluating the functional outcome with special respect to the PQ repair, to the best of our knowledge, no prospective comparative study measuring the objective pronation strength has been published to date [4, 12, 13, 18, 19]
Hershman et al [12] examined the outcome effects in 112 patients treated with or without PQ repair after a follow-up of 1 year. They found no differences in pronation, pain and DASH scores and, concluded that there is no advantage in repairing the PQ muscle during volar plating of distal radius fractures
Summary
The purpose of the present study was to investigate the influence of the pronator quadratus (PQ) mus‐ cle repair following volar plate fixation of distal radius fractures with special regards to the forearm pronation strength. The volar locking plate osteosynthesis has become the treatment of choice for distal radius fractures in recent years This technique enables good functional results with high fragment stability and Häberle et al Eur J Med Res (2015) 20:93 to the poor tissue quality [10]. A number of studies evaluated the efficacy of PQ repair in patients with repair of the PQ muscle versus no repair and reported no differences in terms of functional outcome [12, 13]. These studies lacked objective strength testing in forearm pronation
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