Do we need to suture the pronator quadratus muscle when we do open reduction and internal fixation for fracture of the distal radius
Abstract Background Open reduction and internal fixation is often used for the treatment of distal radius fracture. Opening the pronator quadratus muscle during the process of open reduction and internal fixation is necessary to achieve sufficient exposure. Therefore, knowledge on how to suture the...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-07-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | http://link.springer.com/article/10.1186/s12891-020-03450-8 |
| _version_ | 1818506263059759104 |
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| author | Kaibin Fang Xiaocong Lin Xiaolin Liu Qingfeng Ke Shaoojian Shi Zhangsheng Dai |
| author_facet | Kaibin Fang Xiaocong Lin Xiaolin Liu Qingfeng Ke Shaoojian Shi Zhangsheng Dai |
| author_sort | Kaibin Fang |
| collection | DOAJ |
| description | Abstract Background Open reduction and internal fixation is often used for the treatment of distal radius fracture. Opening the pronator quadratus muscle during the process of open reduction and internal fixation is necessary to achieve sufficient exposure. Therefore, knowledge on how to suture the pronator quadratus muscle will be of essence. Aim The aim of the present study was to determine if suturing the pronator quadratus during the treatment of the distal radius fracture can enhance limb function . Methods A total of 126 patients were enrolled for the study. The patients underwent open reduction and internal fixation. During the procedure, the pronator quadratus was cut open to allow insertion of the plate. The pronator quadratus muscles of the patients were stitched together before the surgery was completed. After the fracture healed, the patients underwent surgery to remove the internal fixations. Patients received wrist function scores prior to removal of the internal fixations. Healing of the pronator quadratus was during surgery. Patients were grouped according to the healing of the pronator quadratus. Functional scores between the two groups were compared. Results Muscle healing was observed in 23 patients during surgery. However, the PQ muscles of these patients were remarkably atrophic, with scar hyperplasia and fibrosis. The muscle fibers were loose, thin, and had decreased in number. The remaining muscle fibers presented different degrees of adhesion with radial carpal flexor muscles, steel plates and interosseous membrane. A total of 23 patients were included in group A and 103 patients in group B based on the intraoperative condition. No statistically significant differences was observed in age and type of fracture between group A and group B. In addition, no statistically significant differences was observed in the isokinetic forearm pronation strength and clinical outcomes including grip strength, wrist ROM, and PRWE scores between the two groups. Conclusion This study demonstrates that healing of the PQ muscle does not affect the outcomes of volar plating for distal radius fractures with reference to the isokinetic forearm rotation strength, grip strength, wrist ROM, and PRWE scores. The results of this study support our current practice of PQ muscle incision. |
| first_indexed | 2024-12-10T22:02:12Z |
| format | Article |
| id | doaj.art-72350096073d4cb3bbe8626dc1b8cce1 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-10T22:02:12Z |
| publishDate | 2020-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-72350096073d4cb3bbe8626dc1b8cce12022-12-22T01:31:52ZengBMCBMC Musculoskeletal Disorders1471-24742020-07-012111710.1186/s12891-020-03450-8Do we need to suture the pronator quadratus muscle when we do open reduction and internal fixation for fracture of the distal radiusKaibin Fang0Xiaocong Lin1Xiaolin Liu2Qingfeng Ke3Shaoojian Shi4Zhangsheng Dai5Department of Orthopaedic Surgery, The Second Affiliated Hospital of Fujian Medical UniversityDepartment of Orthopaedic Surgery, The Second Affiliated Hospital of Fujian Medical UniversityDepartment of Orthopaedic Surgery, The Second Affiliated Hospital of Fujian Medical UniversityDepartment of Orthopaedic Surgery, The Second Affiliated Hospital of Fujian Medical UniversityDepartment of Orthopaedic Surgery, The Second Affiliated Hospital of Fujian Medical UniversityDepartment of Orthopaedic Surgery, The Second Affiliated Hospital of Fujian Medical UniversityAbstract Background Open reduction and internal fixation is often used for the treatment of distal radius fracture. Opening the pronator quadratus muscle during the process of open reduction and internal fixation is necessary to achieve sufficient exposure. Therefore, knowledge on how to suture the pronator quadratus muscle will be of essence. Aim The aim of the present study was to determine if suturing the pronator quadratus during the treatment of the distal radius fracture can enhance limb function . Methods A total of 126 patients were enrolled for the study. The patients underwent open reduction and internal fixation. During the procedure, the pronator quadratus was cut open to allow insertion of the plate. The pronator quadratus muscles of the patients were stitched together before the surgery was completed. After the fracture healed, the patients underwent surgery to remove the internal fixations. Patients received wrist function scores prior to removal of the internal fixations. Healing of the pronator quadratus was during surgery. Patients were grouped according to the healing of the pronator quadratus. Functional scores between the two groups were compared. Results Muscle healing was observed in 23 patients during surgery. However, the PQ muscles of these patients were remarkably atrophic, with scar hyperplasia and fibrosis. The muscle fibers were loose, thin, and had decreased in number. The remaining muscle fibers presented different degrees of adhesion with radial carpal flexor muscles, steel plates and interosseous membrane. A total of 23 patients were included in group A and 103 patients in group B based on the intraoperative condition. No statistically significant differences was observed in age and type of fracture between group A and group B. In addition, no statistically significant differences was observed in the isokinetic forearm pronation strength and clinical outcomes including grip strength, wrist ROM, and PRWE scores between the two groups. Conclusion This study demonstrates that healing of the PQ muscle does not affect the outcomes of volar plating for distal radius fractures with reference to the isokinetic forearm rotation strength, grip strength, wrist ROM, and PRWE scores. The results of this study support our current practice of PQ muscle incision.http://link.springer.com/article/10.1186/s12891-020-03450-8PQ muscleDistal radius fractureOpen reduction and internal fixation |
| spellingShingle | Kaibin Fang Xiaocong Lin Xiaolin Liu Qingfeng Ke Shaoojian Shi Zhangsheng Dai Do we need to suture the pronator quadratus muscle when we do open reduction and internal fixation for fracture of the distal radius BMC Musculoskeletal Disorders PQ muscle Distal radius fracture Open reduction and internal fixation |
| title | Do we need to suture the pronator quadratus muscle when we do open reduction and internal fixation for fracture of the distal radius |
| title_full | Do we need to suture the pronator quadratus muscle when we do open reduction and internal fixation for fracture of the distal radius |
| title_fullStr | Do we need to suture the pronator quadratus muscle when we do open reduction and internal fixation for fracture of the distal radius |
| title_full_unstemmed | Do we need to suture the pronator quadratus muscle when we do open reduction and internal fixation for fracture of the distal radius |
| title_short | Do we need to suture the pronator quadratus muscle when we do open reduction and internal fixation for fracture of the distal radius |
| title_sort | do we need to suture the pronator quadratus muscle when we do open reduction and internal fixation for fracture of the distal radius |
| topic | PQ muscle Distal radius fracture Open reduction and internal fixation |
| url | http://link.springer.com/article/10.1186/s12891-020-03450-8 |
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