Pronator quadratus repair with a part of the brachioradialis muscle insertion in volar plate fixation of distal radius fractures: a prospective randomised trial

Hohendorff, B.; Knappwerth, C; Franke, Jöerg; Müller, Lars Peter; Ries, Christian

doi:10.1007/s00402-018-2999-5

Cited by 25 publications

(33 citation statements)

References 29 publications

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“…We excluded two studies from the Cochrane Central Register of Controlled Trials database, one master’s thesis, which is a review article from the CNKI database, and one RCT that compared PQ repair with no PQ repair with only 3 months of follow-up. Therefore, the meta-analysis included five RCTs [ 8 , 10 , 18 – 20 ] and six retrospective case-control studies [ 7 , 21 – 25 ].…”

Section: Resultsmentioning

confidence: 99%

“…For pronation strength measurement, two studies [ 10 , 18 ] used a baseline hydraulic wrist dynamometer (Fabrication Enterprises), and another two studies [ 25 ] used a hand dynamometer (Qianli, China). For grip strength measurement, three studies [ 8 , 10 , 18 ] used a dynamometer (Jamar; Therapeutic Equipment, Clifton, NJ) and two studies [ 7 , 19 ] did not mention the hand dynamometer model used. One study [ 8 ] provided grip strength data in comparison with those of the uninjured side instead of the actual measured values.…”

Section: Resultsmentioning

confidence: 99%

“…Regarding pronation strength, two studies showed that the pronation strength in the group without PQ repair decreased significantly only in the patients with AO/ OTA type B fractures but not in those with AO/OTA type C fractures [22,25]. One study included patients with AO/OTA type A2, A3, and C1 fractures [18], while another study included patients with AO/OTA type A2, A3, C1-3 fractures [10]. Having better repair quality with preoperatively intact and nicely prepared PQ flaps seems logical.…”

Section: Discussionmentioning

confidence: 99%

“…Although the durability of PQ repair has been supported [5], ensuring good-quality repair, especially in comminuted DRFs with frayed PQ muscles, is sometimes difficult. Two RCTs routinely checked the length or retraction of the PQ in ultrasonography examinations [10,18]. In our included studies, patients in the group without PQ repair who had more metaphyseal displaced and complex fracture patterns had better pronation strengths (Fig.…”

Section: Discussionmentioning

confidence: 99%

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A systematic review and meta-analysis of the pronator quadratus repair following volar plating of distal radius fractures

Liu

Chang

et al. 2020

J Orthop Surg Res

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Background Distal radius fracture (DRF) is the most common upper extremity fracture that requires surgery. Operative treatment with a volar locking plate has proved to be the treatment of choice for unstable fractures. However, no consensus has been reached about the benefits of pronator quadratus (PQ) repair after volar plate fixation of DRF in terms of patient-reported outcome measures, pronation strength, and wrist mobility. Methods We searched the PubMed, Embase, Cochrane Central, and China National Knowledge Infrastructure (CNKI) databases up to March 13, 2020, and included randomized-controlled, non-randomized controlled, or case-control cohort studies that compared cases with and without PQ repair after volar plate fixation of DRF. We used a random-effects model to pool effect sizes, which were expressed as standardized mean differences (SMDs) and 95% confidence intervals. The primary outcomes included Disabilities of the Arm, Shoulder, and Hand scores and pronation strength. The secondary outcomes included the SMDs in pain scale score, wrist mobility, and grip strength. The outcomes measured were assessed for publication bias by using a funnel plot and the Egger regression test. Results Five randomized controlled studies and six retrospective case-control studies were included in the meta-analysis. We found no significant difference in primary and secondary outcomes at a minimum of 6-month follow-up. In a subgroup analysis, the pronation strength in the PQ repair group for AO type B DRFs (SMD = − 0.94; 95% CI, − 1.54 to − 0.34; p < 0.01) favored PQ repair, whereas that in the PQ repair group for non-AO type B DRFs (SMD = 0.39; 95% CI, 0.07–0.70; p = 0.02) favored no PQ repair. Discussion We found no functional benefit of PQ repair after volar plate fixation of DRF on the basis of the present evidence. However, PQ muscle repair showed different effects on pronation strength in different groups of DRFs. Future studies are needed to confirm the relationship between PQ repair and pronation strength among different patterns of DRF. Registration This study was registered in the PROSPERO registry under registration ID No. CRD42020188343. Level of evidence Therapeutic III

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A systematic review and meta-analysis of the pronator quadratus repair following volar plating of distal radius fractures

Liu

Chang

et al. 2020

J Orthop Surg Res

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“…Today, companies offer a wide range of specifically designed plates and screws to provide ideal stabilization for each fracture type. Arthroscopically assisted techniques broadened the technique spectrum especially when reducing intraarticular fractures [28][29][30][31][32][33][34][35]. Selecting the optimal choice from the different options available becomes difficult, especially for young surgeons with minor experience.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical considerations on a CT-based treatment-oriented classification in radius fractures

Hintringer¹,

Rosenauer

Pezzei

et al. 2020

Arch Orthop Trauma Surg

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A wide range of different classifications exist for distal radius fractures (DRF). Most of them are based on plane X-rays and do not give us any information on how to treat these fractures. A biomechanical understanding of the mechanical forces underlying each fracture type is important to treat each injury specifically and ensure the optimal choice for stabilization. The main cause of DRFs are forces acting on the carpus and the radius as well as the position of the wrist in relation to the radius. Reconstructing the mechanism of the injury gives insight into which structures are involved, such as ruptured ligaments, bone fragments as well as the dislocated osteoligamentous units. This article attempts to define certain key fragments, which seem crucial to reduce and stabilize each type of DRF. Once the definition is established, an ideal implant can be selected to sufficiently maintain reduction of these key fragments. Additionally, the perfect approach is selected. By applying the following principles, the surgeon may be assisted in choosing the ideal form of treatment approach and implant selection.

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Radioskapholunäre Arthrodese mit Entfernung des distalen Skaphoidpols von palmar

Quadlbauer

Leixnering

Rosenauer

et al. 2020

Oper Orthop Traumatol

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Pronator quadratus repair with a part of the brachioradialis muscle insertion in volar plate fixation of distal radius fractures: a prospective randomised trial

Cited by 25 publications

References 29 publications

A systematic review and meta-analysis of the pronator quadratus repair following volar plating of distal radius fractures

A systematic review and meta-analysis of the pronator quadratus repair following volar plating of distal radius fractures

Biomechanical considerations on a CT-based treatment-oriented classification in radius fractures

Radioskapholunäre Arthrodese mit Entfernung des distalen Skaphoidpols von palmar

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