Repair of the pronator quadratus muscle in distal radius fractures treated with internal fixation through a palmar approach: a systematic review and meta-analysis.

Article Sidebar

PDF (Español (España))
Published: May 10, 2024
Keywords:
Radius Fractures Wrist Fractures Palmar Plate Pronation

Main Article Content

Laureano A. Hoyos Velasco
Universidad Nacional de Colombia, Bogotá, Colombia
Manuel E. Vergara Amador
Universidad Nacional de Colombia, Bogotá, Colombia
Jhoan F. Muñoz Velasco
Universidad del Valle, Cali, Colombia
Paulo E. Chacón Castillo
Universidad de Antioquia, Medellín, Colombia
Julián A. Arteaga Chima
Universidad de Caldas, Manizales, Colombia

Abstract

Introduction: the pronator quadratus muscle functions as a dynamic stabilizer of the distal radioulnar joint, and its repair after internal fixation with volar locking plate in distal radius fractures is controversial.
Objective: to determine whether the repair of the pronator quadratus muscle influences the clinical and functional outcomes of patients with distal radius fracture who underwent open reduction and internal fixation with volar locking plate.
Materials and methods: a systematic review and meta-analysis were conducted. The analyzed databases were Pubmed/Medline, Embase, and Bireme/Lilacs (search performed until February 20th, 2023). The search terms were distal radius fracture AND volar plate AND pronator quadratus. Methodological quality was determined according to the Cochrane Reviewer’s Handbook.
Results: a total of 4 randomized clinical trials of adequate methodological quality, corresponding to the analysis of 213 participants, were included. Better DASH scores were observed at 12 months of follow-up in the non-repair group of the pronator quadratus muscle, with a mean difference of 2.8 [95% CI 0.51; 5.10]. There were no significant differences at one-year follow-up in pain scores, wrist mobility ranges, grip strength, and incidence of complications.
Conclusion: there is no evidence to support routine repair of the pronator quadratus muscle after internal fixation with volar locking plate in distal radius fractures.

Article Details

How to Cite
1.
Hoyos Velasco LA, Vergara Amador ME, Muñoz Velasco JF, Chacón Castillo PE, Arteaga Chima JA. Repair of the pronator quadratus muscle in distal radius fractures treated with internal fixation through a palmar approach: a systematic review and meta-analysis. Actual. Osteol. [Internet]. 2024 May 10 [cited 2024 Sep. 8];19(3):199-210. Available from: https://ojs.osteologia.org.ar/ojs33010/index.php/osteologia/article/view/65
Issue
Vol. 19 No. 3 (2023): Actualizaciones en Osteología
Section
Reviews

Derechos de autor: Actualizaciones en Osteología es la revista oficial de la Asociación Argentina de Osteología y Metabolismo Mineral (AAOMM) que posee los derechos de autor de todo el material publicado en dicha revista.

References

Chhabra AB, Yildirim B. Adult Distal Radius Fracture Management. J Am Acad Orthop Surg 2021;29(22):1105-16. doi:10.5435/JAAOS-D-20-01335.

Chung KC. The Contemporary View of Distal Radius Fracture Management. Hand Clin 2021;37(2):8. doi:10.1016/j.hcl.2021.03.001.

Rundgren J, Bojan A, Mellstrand Navarro C, Enocson A. Epidemiology, classification, treatment and mortality of distal radius fractures in adults: an observational study of 23,394 fractures from the national Swedish fracture register. BMC Musculoskelet Disord 2020;21(1):88. doi:10.1186/s12891-020-3097-8.

Shapiro LM, Kamal RN; Management of Distal Radius Fractures Work Group; Nonvoting Clinical Contributor; Nonvoting Oversight Chairs; Staff of the American Academy of Orthopaedic Surgeons and the American Society for Surgery of the Hand. Distal Radius Fracture Clinical Practice Guidelines-Updates and Clinical Implications. J Hand Surg Am 2021;46(9):807-11. doi:10.1016/j.jhsa.2021.07.014.

Van Eck ME, Lameijer CM, El Moumni M. Structural validity of the Dutch version of the disability of arm, shoulder and hand questionnaire (DASH-DLV) in adult patients with hand and wrist injuries. BMC Musculoskelet Disord 2018;19(1):207. doi:10.1186/s12891-018-2114-7.

De Villeneuve Bargemon JB, Soudé G, Gras M, Lupon É, Fruchart E. Physical therapy after distal radius fracture. Hand Surg Rehabil 2023;42(2):168-69. doi:10.1016/j.hansur.2022.12.002.

Vaghela KR, Velazquez-Pimentel D, Ahluwalia AK, Choraria A, Hunter A. Distal radius fractures: an evidence-based approach to assessment and management. Br J Hosp Med 2020;81(6):1-8. doi:10.12968/hmed.2020.0006.

Hohendorff B, Knappwerth C, Franke J, Müller LP, Ries C. Pronator quadratus repair with a part of the brachioradialis muscle insertion in volar plate fixation of distal radius fractures: a prospective randomised trial. Arch Orthop Trauma Surg 2018;138(10):1479-85. doi:10.1007/s00402-018-2999-5.

Tang JB. Distal radius fracture: diagnosis, treatment, and controversies. Clin Plast Surg 2014;41(3):481-99. doi:10.1016/j.cps.2014.04.001.

He JJ, Blazar P. Management of High Energy Distal Radius Injuries [published online ahead of print, 2019 Jul 13]. Curr Rev Musculoskelet Med 2019;12(3):379-85. doi:10.1007/s12178-019-09555-5.

Vakhshori V, Alluri RK, Stevanovic M, Ghiassi A. Review of Internal Radiocarpal Distraction Plating for Distal Radius Fracture Fixation. Hand 2020;15(1):116-24. doi:10.1177/1558944718787877.

Unglaub F, Langer MF, Hohendorff B, et al. Distal radius fracture of the adult : Diagnostics and therapy. Orthopade 2017;46(1):93-110. doi:10.1007/s00132-016-3347-5.

Lubbe RJ, Kokmeyer DT, Young CP. Distal Radius Fractures: Recognizing and Treating Complex Fracture Patterns. J Orthop Trauma 2021;35:33-6. doi:10.1097/BOT.0000000000002209.

Sobel AD, Calfee RP. Distal Radius Fractures in the Athlete. Clin Sports Med 2020;39(2):299-311. doi:10.1016/j.csm.2019.10.005.

Abdel Wahed M, Khater AA, El-Desouky MA. Volar locking plate fixation for distal radius fractures: did variable-angle plates make difference?. Int Orthop 2022;46(9):2165-76. doi:10.1007/s00264-022-05469-z.

Joo MS, Kang HJ, Yu HK, Lee JS. Outcomes of Primary Volar Locking Plate Fixation of Open Distal Radius Fractures. J Hand Surg Asian Pac Vol 2022;27(3):517-23. doi:10.1142/S2424835522500527.

Omokawa S, Abe Y, Imatani J, Moritomo H, Suzuki D, Onishi T. Treatment of Intra-articular Distal Radius Fractures. Hand Clin 2017;33(3):529-43. doi:10.1016/j.hcl.2017.04.009.

Zhang D, Meyer MA, Earp BE, Blazar P. Role of Pronator Quadratus Repair in Volar Locking Plate Treatment of Distal Radius Fractures. J Am Acad Orthop Surg 2022;30(15):696-702. doi:10.5435/JAAOS-D-22-00083.

Shi F, Ren L. Is pronator quadratus repair necessary to improve outcomes after volar plate fixation of distal radius fractures? A systematic review and meta-analysis. Orthop Traumatol Surg Res 2020;106(8):1627-35. doi:10.1016/j.otsr.2020.06.003.

Oliveros H. La heterogeneidad en los metaanálisis, ¿es nuestra mejor aliada? Rev Colomb Anestesiol 2015. 43 (3): 176-78.

Goorens CK, De Keyzer PB, Van Royen K, Provyn S, Goubau JF. Pronator quadratus repair after volar plate fixation in distal radial fractures: evaluation of the clinical and functional outcome and of the protective role on the flexor tendons-a randomized controlled study. Eur J Orthop Surg Traumatol 2021;31(3):541-48. doi:10.1007/s00590-020-02804-1.

Tosti R, Ilyas AM. Prospective evaluation of pronator quadratus repair following volar plate fixation of distal radius fractures. J Hand Surg Am 2013;38(9):1678-84. doi:10.1016/j.jhsa.2013.06.006.

Sonntag J, Woythal L, Rasmussen P, et al. No effect on functional outcome after repair of pronator quadratus in volar plating of distal radial fractures: a randomized clinical trial. Bone Joint J 2019;101-B(12):1498-505. doi:10.1302/0301-620X.101B12.BJJ-2019-0493.R1.

Germann G, Wind G, Harth A. Der DASH-Fragebogen--Ein neues Instrument zur Beurteilung von Behandlungsergebnissen an der oberen Extremität [The DASH(Disability of Arm-Shoulder-Hand) Questionnaire--a new instrument for evaluating upper extremity treatment outcome]. Handchir Mikrochir Plast Chir 1999;31(3):149-52. doi:10.1055/s-1999-13902.

Wiitavaara B, Florin J. Content and psychometric evaluations of questionnaires for assessing physical function in people with arm-shoulder-hand disorders. A systematic review of the literature. Disabil Rehabil 2022;44(24):7575-86. doi:10.1080/09638288.2021.1979109.

Polson K, Reid D, McNair PJ, Larmer P. Responsiveness, minimal importance difference and minimal detectable change scores of the shortened disability arm shoulder hand (QuickDASH) questionnaire. Man Ther 2010;15(4):404-07. doi:10.1016/j.math.2010.03.008.

Mulders MAM, Walenkamp MMJ, Bos FJME, Schep NWL, Goslings JC. Repair of the pronator quadratus after volar plate fixation in distal radius fractures: a systematic review. Strategies Trauma Limb Reconstr 2017;12(3):181-88. doi:10.1007/s11751-017-0288-4.

Ying L, Cai G, Zhu Z, Yu G, Su Y, Luo H. Does pronator quadratus repair affect functional outcome following volar plate fixation of distal radius fractures? A systematic review and meta-analysis. Front Med 2023;10:992493. doi:10.3389/fmed.2023.992493.

Lu CK, Liu WC, Chang CC, Shih CL, Fu YC, Jupiter JB. A systematic review and meta-analysis of the pronator quadratus repair following volar plating of distal radius fractures. J Orthop Surg Res 2020 16;15(1):419. doi: 10.1186/s13018-020-01942-w.

Hershman SH, Immerman I, Bechtel C, Lekic N, Paksima N, Egol KA. The effects of pronator quadratus repair on outcomes after volar plating of distal radius fractures. J Orthop Trauma 2013;27(3):130-33. doi:10.1097/BOT.0b013e3182539333.