Réparation du pronator quadratus par surjet aller-retour dans la voie de Henry

Erhard, L.; Farah, César; Elkholti, Kamil; Ninou, M.; Rostoucher, P.

doi:10.1016/s0035-1040(07)90280-9

Cited by 15 publications

(3 citation statements)

References 11 publications

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“…In contrast, various suture techniques for re-fixation of the PQ are described in the literature. These include the simple interrupted suture, the braided suture, the suture combined with prolonged immobilisation or the suture of the PQ together with connective tissue fibres from the first extensor tendon compartment or the palmar limb of the brachioradialis tendon [22,23].…”

Section: Discussionmentioning

confidence: 99%

Does access through the pronator quadratus influence pronation strength in palmar plate fixation of distal radius fractures in elderly patients?

Falk

Maksimow

Mittlmeier

et al. 2023

Arch Orthop Trauma Surg

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Introduction Palmar plate fixation of the distal radius fracture involves dissecting the pronator quadratus (PQ). This is regardless of whether the approach is radial or ulnar to the flexor carpi radialis (FCR) tendon. It is not yet clear whether and to what extent this dissection leads to a functional loss of pronation or pronation strength. The aim of this study was to investigate the functional recovery of pronation and pronation strength after dissection of the PQ without suturing. Materials and methods From October 2010 to November 2011, patients aged over 65 with fracture were prospectively enrolled in this study. Fracture stabilisation was performed via the FCR approach without suturing the PQ. Follow-up examinations took place 8 weeks and 12 months postoperatively, and pronation and supination strength were analysed by means of an especially developed measuring device. Results 212 patients were initially screened and 107 were enrolled. The range of motion compared to the healthy opposite side was Ext/Flex 75/66% 8 weeks postoperatively. Pronation was 97% with a pronation strength of 59%. After 1 year, the scores improved to Ext/Flex 83/80%. Pronation recovered to 99% and pronation strength to 78%. Conclusion The present study can show a recovery of pronation as well as pronation strength in a large patient population. At the same time, the pronation strength is still significantly lower 1 year after the operation than on the opposing healthy side. As the pronation strength recovers as the grip strength and is at all times on a par with the supination strength, we believe that we can continue to refrain from re-fixating the pronator quadratus.

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Section: Discussionmentioning

confidence: 99%

Does access through the pronator quadratus influence pronation strength in palmar plate fixation of distal radius fractures in elderly patients?

Falk

Maksimow

Mittlmeier

et al. 2023

Arch Orthop Trauma Surg

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“…15,16 To our knowledge, three techniques have so far been represented to facilitate PQ repair. [17][18][19] Erhard et al reach the radius with a longitudinal incision from the middle part of the PQ and suture the muscle and fascia with the overlock method after the procedure. 17 The fiber structure of normal muscle tissue does not endorse suturing, and muscle that has been cut is best treated by repair of the overlying fascia, which has a high collagen density.…”

Section: Funding 11mentioning

confidence: 99%

“…[17][18][19] Erhard et al reach the radius with a longitudinal incision from the middle part of the PQ and suture the muscle and fascia with the overlock method after the procedure. 17 The fiber structure of normal muscle tissue does not endorse suturing, and muscle that has been cut is best treated by repair of the overlying fascia, which has a high collagen density. 20 In this technique, suture resistance is expanded owing to locked sutures.…”

Section: Funding 11mentioning

confidence: 99%

A New Repair Technique in Pronator Quadratus in Management of Distal Radius Fracture: Comparison with Primary Repair and Unrepaired Techniques

et al. 2023

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Objective We aimed to compare the functional and clinical results between our new repair technique in the groups with and without pronator quadratus (PQ) repair in distal radius fractures treated with plate fixation using the volar approach. Methods The medical records of patients who underwent open reduction and volar plate fixation due to distal radius fracture between 2018 and 2020 were studied. In group A, PQ cannot be sutured or tension may occur, the intact radial fascia of the deep anterior fascia (DAF) was placed under the flexors toward the PQ and it was sutured with a 3-0 slow-absorbable monofilament suture to DAF. In group B, no repair was performed. In group C, PQ was sutured with traditional method. Range of motion (ROM) of wrist and handgrip strengths were measured at final examination. Pain was assessed with Visual Analogue Score (VAS), and functional status was evaluated with Quick - Disabilities of the Arm, Shoulder, and Hand (DASH). Complications which included tendinopathy, neuritis, tendon rupture due to plate irritation, implant failure, and malunion were also compared. Results Seventy-seven patients (group A, 21, group B, 24, group C, 32 patients) were included in the final follow-up examination who met our inclusion criteria. Among the clinical, functional, and radiological results such as ROM, VAS, DASH, grip strength, and complications in the all group at a mean postoperative of 16.6 months no significant difference was observed. Conclusion Although there was no significant difference between the groups in this study, we think that covering the plate may prevent long-term complications.

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Ultrasound Evaluation of the Protector Role of the Pronator Quadratus Suture in Volar Plating

Walch

Erhard

Vogels

et al. 2019

J of Ultrasound Medicine

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The main complication of volar locking plates for distal radius fractures is flexor tendon rupture. The flexor pollicis longus (FPL) is the most commonly ruptured. Repair of the pronator quadratus (PQ) is one of the ways to prevent tendon rupture. The main purpose of this series was to evaluate the role of PQ repair after volar plating to prevent flexor tendon rupture using ultrasound (US). This work was a mono-operator prospective series of 20 consecutive patients with volar locking plates for distal radius fracture between September 2014 and May 2015. The PQ was repaired in all patients. A clinical, ultrasound, and perioperative evaluation of the flexor tendon was performed by this same surgeon. There was no flexor tendon rupture or tenosynovitis. There were no type A cases, which are characterized by contact between the plate and the FPL, and mostly type C cases, which are characterized by no contact between the plate and the FPL on US imaging. The suture of the PQ was sustainable over time when we removed the plate. Pronator quadratus repair is one of the ways to prevent flexor tendon rupture after volar plating. The outward-running suture is an effective technique for repairing the PQ. Ultrasound may be helpful during follow-up to detect asymptomatic flexor tendon irritation.

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Réparation du pronator quadratus par surjet aller-retour dans la voie de Henry

Cited by 15 publications

References 11 publications

Does access through the pronator quadratus influence pronation strength in palmar plate fixation of distal radius fractures in elderly patients?

Does access through the pronator quadratus influence pronation strength in palmar plate fixation of distal radius fractures in elderly patients?

A New Repair Technique in Pronator Quadratus in Management of Distal Radius Fracture: Comparison with Primary Repair and Unrepaired Techniques

Ultrasound Evaluation of the Protector Role of the Pronator Quadratus Suture in Volar Plating

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