J Korean Fract Soc.  2014 Jul;27(3):191-197. 10.12671/jkfs.2014.27.3.191.

The Fate of Pronator Quadratus Muscle after Volar Locking Plating of Unstable Distal Radius Fractures

• Lim CH
• Jung HG
• Heo JY
• Jang YJ
• Choi YS

• KMID: 1708711
• DOI: http://doi.org/10.12671/jkfs.2014.27.3.191

Abstract

PURPOSE
The purpose of this study is to evaluate the pronator quadrates muscle in patients who underwent internal fixation with a volar locking plate for unstable distal radius fractures.
MATERIALS AND METHODS
Forty patients who underwent internal fixation with a volar locking plate for unstable distal radius fracture were enrolled. We evaluated the clinical results according to the Mayo wrist score, the wrist range of motion, and the grip strength at the last follow-up. Using ultrasonography, muscle thickness of the pronator quadrates was compared between injured and uninjured arm.
RESULTS
Bone union was achieved in all cases. The mean Mayo wrist score was 82.79 points. The grip strength of the injured arm was decreased to 89.1% of the uninjured side. The decrease of pronation range of the injured wrist motions was significant (82.3degrees, p=0.004). There was significant atrophy of the pronator quadrates muscle on the injured side (injured side: 3.19 mm, uninjured side: 4.72 mm, p=0.001); and the decrement of muscle thickness in pronator quadrates showed an association with the Mayo wrist score (r=-0.35, p=0.042).
CONCLUSION
These results suggest that continuity of the muscle is maintained after use of the volar locking plating for unstable distal radius fractures with repair of pronator quadrates; however, there is atrophy of pronator quadrates muscle and limitation of pronation in the injured wrist.

Keyword

Distal radius fracture; Volar locking plate; Pronator quadratus muscle

MeSH Terms

Arm
Atrophy
Follow-Up Studies
Hand Strength
Humans
Pronation
Radius Fractures*
Range of Motion, Articular
Ultrasonography
Wrist

Figure

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  Fig. 1 During surgical procedures for pronator quadratus muscle, detached muscle was repaired with 4 or 5 interrupted matrix sutures with 3-0 Vicryl after the fracture fixation.

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  Fig. 2 Ultrasound examinations were performed bilaterally at pronator quadrates muscle (asterisk). (A) Transverse view and longitudinal view of the uninjured side. (B) Transverse view and longitudinal view of the injured side.

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  Fig. 3 In a 65-year-old man with an AO type C3 distal radius fracture, gross photo at plate removal showed atrophy of pronator quadratus muscle.

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