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

Chae-Hyun Lim; Heun-Guyn Jung; Ju-Yeong Heo; Young-Jae Jang; Yong-Soo Choi

doi:10.12671/jkfs.2014.27.3.191

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Lim, Jung, Heo, Jang, and Choi: The Fate of Pronator Quadratus Muscle after Volar Locking Plating of Unstable Distal Radius Fractures

Original Article

Journal of the Korean Fracture Society 2014; 27(3): 191-197.

Published online: 16 July 2014

DOI: https://doi.org/10.12671/jkfs.2014.27.3.191

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

Chae-Hyun Lim, M.D., Heun-Guyn Jung, M.D., Ju-Yeong Heo, M.D., Young-Jae Jang, M.D., Yong-Soo Choi, M.D.

Department of Orthopedic Surgery, Kwangju Christian Hospital, Gwangju, Korea.

Address reprint requests to: Heun-Guyn Jung, M.D. Department of Orthopedic Surgery, Kwangju Christian Hospital, 37 Yangrim-ro, Nam-gu, Gwangju 503-715, Korea. Tel: 82-62-650-5064, Fax: 82-62-650-5066, handmicro@naver.com

Received 18 November 2013 Revised 24 March 2014 Accepted 28 March 2014

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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 (82.3°, 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.

Keywords: Distal radius fracture, Volar locking plate, Pronator quadratus muscle

Figures and Tables

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.

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.

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.

Table 1

Demographic Characteristics

Values are presented as number, number (%), or median (range).

Table 2

Comparison of Range of Motion of the Wrist and Muscle Thickness of Pronator Quadratus between Injured Side and Uninjured Side at Last Follow Up

Values are presented as mean±standard deviation.

Table 3

Correlation Analysis of Clinical Results and Difference of Pronator Quadratus Muscle Thickness

Notes

Financial support: None.

Conflict of interest: None.

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