Role of Pronator Quadratus Repair in Volar Locking Plate Treatment of Distal Radius Fractures.

Dafang Zhang, Maximilian A Meyer, Brandon E. Earp, P. Blazar
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引用次数: 1

Abstract

Distal radius fractures are the most common type of upper extremity fractures, and their incidence is increasing. There has been a rise in the surgical treatment of distal radius fractures, primarily with volar locking plate fixation. Although this procedure is commonly done among orthopaedic surgeons, the role of pronator quadratus repair after fixation remains controversial. The pronator quadratus serves as a secondary forearm pronator and a dynamic stabilizer of the distal radioulnar joint. Aside from a functional role, repair of the pronator quadratus has been proposed to serve as a biologic barrier between the volar locking plate and the flexor tendons to minimize tendon irritation. In this narrative review, we discuss the current treatment trends, the surgical approach for volar locking plate treatment of distal radius fractures, and the anatomy and function of the pronator quadratus. We discuss the case for and against the repair of the pronator quadratus, both for function and prevention of flexor tendon irritation and rupture. The preponderance of high-level evidence demonstrates no benefit to pronator quadratus repair for pain relief or function. The current evidence does not conclusively support or refute pronator quadratus repair as a biologic barrier from the flexor tendons.
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旋前方肌修复在掌侧锁定钢板治疗桡骨远端骨折中的作用。
桡骨远端骨折是上肢骨折中最常见的类型,其发病率呈上升趋势。桡骨远端骨折的手术治疗越来越多,主要采用掌侧锁定钢板固定。虽然这种手术在骨科医生中很常见,但固定后旋前方肌修复的作用仍然存在争议。旋前方肌作为前臂第二旋前肌和远端尺桡关节的动态稳定器。除了功能性作用外,已提出修复旋前方肌作为掌侧锁定钢板和屈肌腱之间的生物屏障,以减少对肌腱的刺激。在这篇叙述性回顾中,我们讨论了目前的治疗趋势,掌侧锁定钢板治疗桡骨远端骨折的手术入路,以及旋前方肌的解剖和功能。我们讨论的情况下,支持和反对修复旋前方肌,既功能和预防屈肌腱刺激和断裂。高水平证据的优势表明,方旋肌修复对缓解疼痛或功能没有好处。目前的证据并不能决定性地支持或反驳方旋肌修复作为屈肌腱的生物屏障。
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