Assessment of Pronator Quadratus Repair Integrity Using Dynamic Ultrasonography Following Volar Plate Fixation for...

Area of Science:

• Orthopedic Surgery
• Musculoskeletal Imaging
• Reconstructive Surgery

Background:

• Previous studies indicated potential failure of pronator quadratus (PQ) repair post-volar plate fixation (VPF) for distal radius fractures (DRF).
• Assessing the integrity of PQ repair is crucial for understanding functional outcomes after DRF treatment.

Purpose of the Study:

• To evaluate the integrity of the pronator quadratus (PQ) repair following volar plate fixation (VPF) of distal radius fractures (DRF).
• To assess the relationship between PQ repair integrity, volar plate coverage, and functional outcomes using dynamic musculoskeletal ultrasonography.

Main Methods:

• Twenty adult patients undergoing VPF of DRF with PQ repair were evaluated using bilateral dynamic wrist ultrasonography.
• Assessments included PQ repair integrity, wrist range of motion (ROM), strength, and functional outcome scores at a minimum 3-month follow-up.

Main Results:

• All patients demonstrated intact pronator quadratus (PQ) repairs at a mean follow-up of 9 months.
• Complete coverage of the volar plate by the PQ occurred in 55% of patients, associated with a larger PQ size (P = .026).
• No significant differences in ROM, strength, or functional outcomes were observed between wrists with complete or incomplete volar plate coverage by the PQ.

Conclusions:

• Pronator quadratus (PQ) repair exhibits significant durability after volar plate fixation (VPF) for distal radius fractures (DRF).
• Functional outcomes, including wrist range of motion and strength, are comparable whether the volar plate is fully or partially covered by the repaired PQ.