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J Wrist Surg 2021; 10(05): 407-412
DOI: 10.1055/s-0041-1730341
Scientific Article

Should We Repair the Pronator Quadratus in a Distal Radius Fracture with an Ulnar Styloid Base Fracture? A Biomechanical Study

Mauro Maniglio
1   Department of Orthopaedics and Traumatology, Inselspital Bern, University Hospital, Bern, Switzerland
,
Victor Truong
2   Orthopaedic Biomechanics Laboratory, Congress Medical Foundatiom, Pasadena, California
,
Matthias Zumstein
3   Orthopaedics Sonnenhof, Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland
,
Lilianna Bolliger
1   Department of Orthopaedics and Traumatology, Inselspital Bern, University Hospital, Bern, Switzerland
,
Michelle H. McGarry
2   Orthopaedic Biomechanics Laboratory, Congress Medical Foundatiom, Pasadena, California
,
Thay Q. Lee
2   Orthopaedic Biomechanics Laboratory, Congress Medical Foundatiom, Pasadena, California
› Author Affiliations Funding None.
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Abstract

Background Merits of repairing the pronator quadratus (PQ) to restore distal radioulnar joint (DRUJ) stability after a volar approach remain controversial. Distal radius fractures are often associated with ulnar styloid fractures (USF). When involving the fovea, this USF can lead to a DRUJ instability. The PQ repair may be key in reducing this DRUJ instability.

Methods This study aims to assess the biomechanical role of PQ repair in a cadaveric model of USF. In 17 forearm specimens, a USF including the fovea was executed. Positional changes of the DRUJ in forearm rotation and dorso-palmar (DP) translation were measured with variable loads (0, 2.5, and 5N) applied to the PQ origin.

Results Forearm rotation and DP-translation decreased significantly with PQ loading of 5N, changing on average by 5 degrees and 0.6 mm, respectively.

Conclusion We found a significant decrease in forearm rotation and DP-translation comparing a fully loaded PQ to an unloaded PQ in our cadaveric model.

Keywords

distal radio-ulnar joint - distal radio-ulnar ligaments - distal radius fracture - pronator quadrates - ulnar styloid fracture


Publication History

Received: 29 September 2020

Accepted: 13 April 2021

Article published online:
21 June 2021

© 2021. Thieme. All rights reserved.

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