Pronator quadratus muscle flap: a preliminary cadaveric study

Area of Science:

• Anatomy
• Microsurgery
• Reconstructive Surgery

Background:

• Limited research exists on the pronator quadratus (PQ) muscle's neurovascular anatomy and harvesting techniques.
• Understanding these details is crucial for its application in free functional muscle transfer.

Purpose of the Study:

• To detail the neurovascular anatomy of the pronator quadratus (PQ) muscle.
• To describe the technique for harvesting the PQ muscle.
• To review existing clinical applications of the PQ muscle transfer.

Main Methods:

• Cadaveric dissections of four fresh upper extremities were performed.
• Detailed measurements of the PQ muscle and its neurovascular pedicle were recorded.
• Anatomical relationships and branching patterns were documented.

Main Results:

• The pronator quadratus (PQ) muscle's neurovascular pedicle originates from the anterior interosseous artery (AIA) and nerve.
• The average pedicle length was approximately 12 cm, with a diameter of 2.25 mm.
• The PQ muscle was easily harvested within 30 minutes, showing adequate vessel and nerve length for microvascular procedures.

Conclusions:

• The pronator quadratus (PQ) muscle is a viable option for free or pedicled muscle transfer due to its accessible neurovascular supply.
• It offers a short learning curve and minimal donor site morbidity.
• Further research is needed to establish definitive indications for its use in reconstructive surgery.