title: Significance of a Pronator Quadratus-Sparing Approach for Volar Locking Plate Fixation of Comminuted Intra-articular Fractures of the Distal Radius.
abstract: BACKGROUND
  The preservation of the integrity of the pronator quadratus (PQ) muscle is expected to have many benefits, particularly in cases of highly comminuted intra-articular fractures of the distal radius. Therefore, we examined the significance of a PQ muscle-sparing approach for volar locking plate (VLP) fixation of these types of fractures.
  
  
  METHODS
  Sixty-five patients who sustained AO Foundation and Orthopaedic Trauma Association (AO/OTA) type C2 and C3 distal radius fractures were treated with VLP fixation using either a PQ muscle release and repair (PQ-releasing group, n = 30) or a PQ muscle-sparing approach (PQ-sparing group, n = 35). Radiographic parameters, active range of motion (ROM), percentage of the grip power of the injured hand compared with that of the opposite hand, wrist pain visual analog scale (VAS) score, and Quick Disability of the Arm, Shoulder, and Hand (DASH) score (disability/symptom) were evaluated monthly up to 12 months after surgery.
  
  
  RESULTS
  The mean VAS score was significantly lower in the PQ-sparing group at 2, 3, and 4 months postoperatively than in the PQ-releasing group. Furthermore, the mean Quick DASH score in the PQ-sparing group was significantly lower than that in the PQ-releasing group at 1 and 2 months postoperatively. There were no significant differences, however, in the other functional parameters in the groups through the observation period.
  
  
  CONCLUSIONS
  The PQ muscle-sparing approach appears to achieve satisfactory results in patients undergoing VLP fixation of comminuted intra-articular fractures of the distal radius.
authors.affiliation: Kawakita General Hospital, Tokyo, Japan; Sakurakai Hospital, Tokyo, Japan.
authors.forename: Soichiro
authors.initials: S
authors.lastname: Itoh
authors.affiliation: Kawakita General Hospital, Tokyo, Japan.
authors.forename: Myu
authors.initials: M
authors.lastname: Yumoto
authors.affiliation: Kawakita General Hospital, Tokyo, Japan.
authors.forename: Misa
authors.initials: M
authors.lastname: Kanai
authors.affiliation: Kawakita General Hospital, Tokyo, Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Yoshida
authors.affiliation: Kawakita General Hospital, Tokyo, Japan.
authors.forename: Taro
authors.initials: T
authors.lastname: Yoshioka
keywords: comminuted intra-articular fracture; distal radius fracture; pronator quadratus muscle; surgical approach; volar locking plate