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The effects of pronator quadratus repair on outcomes after volar plating of distal radius fractures.

Abstract：

OBJECTIVES:The purpose of this study was to evaluate forearm rotation after volar plating of the distal radius fractures with and without pronator quadratus repair. DESIGN:This was an institutional review board-approved retrospective review of prospectively collected data. SETTING:The study was conducted at an Academic Medical Center. PATIENTS:Over a 5-year period, 606 patients with distal radius fractures (OTA classifications 23-A through 23-C) were enrolled in an institutional review board-approved, prospectively collected, distal radius database. One hundred and seventy-five patients underwent open reduction and internal fixation with volar plating. Of these, 112 patients had complete 1-year follow-up (6 weeks, 3, 6, and 12 months) and were included in this study. INTERVENTION:Volar plating of the distal radius was performed with pronator quadratus repair (group A), versus volar plating without pronator quadratus repair (group B). Surgeries in group A were performed by a fellowship trained hand surgeon utilizing volar plates from Depuy Orthopedics (Warsaw, IN), whereas the surgeries in group B were performed by a fellowship trained orthopedic trauma surgeon utilizing volar plates from Stryker (Mahwah, NJ). MAIN OUTCOME MEASUREMENTS:Primary outcomes include forearm range of motion. Secondary outcomes include grip strength, pain levels, functional outcomes (DASH scores), radiographs, and complications. RESULTS:Baseline and demographic characteristics of the patients were similar between the 2 groups. There was no difference in mean pronation (P = 0.08) at 1 year. Among secondary analyses, radial deviation was significantly different (P = 0.03); however, pain (P = 0.13) and DASH scores (P = 0.14) were not. The only patient that requested plate removal had the pronator repaired (group A). CONCLUSIONS:We conclude that there is no advantage in repairing the pronator quadratus during volar plating of distal radius fractures. LEVEL OF EVIDENCE:Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

journal_name

J Orthop Trauma

journal_title

Journal of orthopaedic trauma

authors

Hershman SH,Immerman I,Bechtel C,Lekic N,Paksima N,Egol KA

doi

10.1097/BOT.0b013e3182539333

subject

Has Abstract

pub_date

2013-03-01 00:00:00

pages

130-3

issue

eissn

0890-5339

issn

1531-2291

journal_volume

pub_type

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The effects of pronator quadratus repair on outcomes after volar plating of distal radius fractures.