title: Pronator quadratus repair after volar plating of distal radius fractures or not? Results of a prospective randomized trial.
abstract: BACKGROUND
  The purpose of the present study was to investigate the influence of the pronator quadratus (PQ) muscle repair following volar plate fixation of distal radius fractures with special regards to the forearm pronation strength. During the early recovery period of 3 months, an improvement of pronation strength and functional scorings was hypothesized for the PQ repair when compared to no repair.
  
  
  METHODS
  The inclusion criteria were (1) men or women between 18 and 80 years, (2) isolated, closed fractures of the distal radius, (3) A2 to B2 types of fracture according to the AO fracture classification system, (4) primary volar locking plate osteosynthesis. Patients were randomized to group A = PQ repair and group B = no repair. Follow-up examinations after 6 and 12 weeks included bilateral isometric pronation strength measurement, range of motion, the QuickDASH and the Mayo-Wrist-Score, and a visual analog scale (VAS).
  
  
  RESULTS
  60 patients (n = 31 in group A and n = 29 in group B) with an average age of 54 years (range 22-77 years) returned for both follow-up visits. The pronation strength measurements showed no significant differences between groups (PQ repair vs. no repair) neither at 6 weeks nor at 12 weeks. Additionally, no statistical significant differences were noted for ROM, QuickDASH-Score or Mayo-Wrist-Score. The VAS scoring revealed a significant decreased pain level after PQ repair at 6 weeks postoperatively (p = 0.017).
  
  
  CONCLUSIONS
  An improved pronation strength after PQ repair in the early rehabilitation period could not be confirmed. However, the PQ repair might reduce pain in the early postoperative period.
  
  
  BACKGROUND
  NCT02595229 (ClinicalTrials.gov, registered 02 November 2015).
authors.affiliation: Department of Trauma Surgery, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany. sandra.haeberle@mri.tum.de.
authors.forename: Sandra
authors.initials: S
authors.lastname: Häberle
authors.affiliation: BG Trauma Center, Eberhard Karls University, Schnarrenbergerstr. 95, 72076, Tübingen, Germany. g_sandmann@hotmail.com.
authors.forename: Gunther Hubertus
authors.initials: GH
authors.lastname: Sandmann
authors.affiliation: Department of Trauma Surgery, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany. stephan.deiler@mri.tum.de.
authors.forename: Stephan
authors.initials: S
authors.lastname: Deiler
authors.affiliation: BG Trauma Center, Eberhard Karls University, Schnarrenbergerstr. 95, 72076, Tübingen, Germany. tkraus@bgu.tuebingen.de.
authors.forename: Tobias Maximilian
authors.initials: TM
authors.lastname: Kraus
authors.affiliation: Department of Trauma Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany. f.fensky@uke.de.
authors.forename: Florian
authors.initials: F
authors.lastname: Fensky
authors.affiliation: Department of Trauma Surgery, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany. ttorsiglieri@ukaachen.de.|Department of Oral, Maxillofacial and Plastic Facial Surgery, RWTH Aachen University Hospital, Templergraben 55, 52062, Aachen, Germany. ttorsiglieri@ukaachen.de.
authors.forename: Tobias
authors.initials: T
authors.lastname: Torsiglieri
authors.affiliation: Institute of Medical Statistics and Epidemiology, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany. ina.rondak@tum.de.
authors.forename: Ina-Christine
authors.initials: IC
authors.lastname: Rondak
authors.affiliation: Department of Trauma Surgery, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany. peter.biberthaler@mri.tum.de.
authors.forename: Peter
authors.initials: P
authors.lastname: Biberthaler
authors.affiliation: BG Trauma Center, Eberhard Karls University, Schnarrenbergerstr. 95, 72076, Tübingen, Germany. ustoeckle@bgu.tuebingen.de.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Stöckle
authors.affiliation: Department of Trauma Surgery, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany. sebastian.siebenlist@mri.tum.de.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Siebenlist
mesh_terms: D000328:Adult; D000368:Aged; D001860:Bone Plates; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000293:injuries; D019637:Orthopedic Procedures / Q000379:methods*; D011885:Radius Fractures / Q000601:surgery / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult