J Korean Orthop Assoc.  2012 Feb;47(1):48-53. 10.4055/jkoa.2012.47.1.48.

Anatomical Study of the Pronator Quadratus Muscle and Comparison to Fracture Sites of the Distal Radius

• Jung GH
• Cho CH
• Kim JD

• KMID: 1439992
• DOI: http://doi.org/10.4055/jkoa.2012.47.1.48

Abstract

PURPOSE
To collect data regarding the pronator-sparing approach using an anatomical study, which compared the fractures of the distal radius and pronator quadratus (PQ) muscle of an adult cadaveric radius.
MATERIALS AND METHODS
Fourteen adult cadaver wrists that did not have previous fractures or previous surgery and computed tomography data 32 fractures of the distal radius, were obtained. The size of the distal fracture fragment was measured using the picture archiving and communication system. The distance between the distal margin of the PQ muscles and the articular margin was measured using a caliper.
RESULTS
The PQ muscles had an average distance of 10.9 mm (range, 8-13 mm) from the radial styloid process and 10 mm (range, 8-12 mm) from the distal radioulnar joint (DRUJ). The fracture sites were located an average of 21.8 mm (range, 10-39 mm) from the radial styloid process and an average of 14.4 mm (range, 10-28 mm) from the DRUJ. Distal radial fractures overlapped an average of 11.8 mm from the radial styloid process and an average of 3.5 mm from the DRUJ.
CONCLUSION
The pronator-sparing approach could be applied to a functionally reduced fracture because the non-overlapping area of the distal fracture fragment was > or =10 mm and it is possible to repair the anatomic plate without detaching the PQ muscle.

Keyword

pronator quadratus muscle; distal radius fracture; pronator-sparing approach

MeSH Terms

Adult
Cadaver
Humans
Joints
Muscles
Radius
Wrist

Figure

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  Figure 1 A computed tomography scan shows the distal fragment size of fracture from distal articular surface (arrow) using the picture archiving communicating system.

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  Figure 2 The distal (A) and proximal margin (B) of pronator quadratus muscle is measured using a caliper.

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  Figure 3 After the dissection, we could identify two types of the distal and radial attachment (asterisk) of pronator quadratus muscle; (A) out of the pronator fossa and (B) in the pronator fossa.

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  Figure 4 (A, B) The distal fragment of fracture is big enough to fix the distal screw row of precontoured plate (volar juxta-articular plate, LDRS®, Synthes, Oberdorf, Switzerland) without detachment of pronator quadratus muscle; outer lines, margins of pronator quadratus muscle; middle line, fracture site; PQ, pronator quadratus.

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  Figure 5 After volar plate fixation, the preserved pronator quadratus muscle and distal row of screws are visible in the distal incision.

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