Pronator quadratus preserving versus pronator quadratus dissecting approaches in volar plate fixation of distal radius fractures: a systematic review of comparative studies.

Autor: Vivekanantha P; Michael DeGroote School of Medicine, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada. prushoth.vivekanantha@medportal.ca., Soeder J; Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada., Kruse C; Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada., McKechnie T; Division of General Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada., Abdel Khalik H; Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada., Selznick A; Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada., Johal H; Division of General Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada.; Section of Orthopedic Surgery, Department of Surgery, University of Calgary, Calgary, AB, Canada.
Jazyk: angličtina
Zdroj: European journal of orthopaedic surgery & traumatology : orthopedie traumatologie [Eur J Orthop Surg Traumatol] 2024 Jul; Vol. 34 (5), pp. 2289-2302. Date of Electronic Publication: 2024 Apr 27.
DOI: 10.1007/s00590-024-03967-x
Abstrakt: Purpose: To compare pronator quadratus preserving (PQ-P) approaches with PQ dissecting (PQ-D) approaches in volar plate fixation of distal radius fractures (DRFs).
Methods: Three databases were searched on March 10th, 2024. The authors adhered to the PRISMA and R-AMSTAR guidelines and Cochrane Handbook for Systematic Reviews. Data on demographics, fracture classifications, patient reported outcome measures (PROMs), range of motion, radiographic parameters, and complications were extracted.
Results: Thirteen studies with a total of 1007 fractures were included. Two of three studies reported lower DASH scores in the PQ-P group between 6 weeks and 3 months postoperative, however no studies reported lower scores in the PQ-P group after 3 months. Three of three studies reported significantly lower VAS scores at 6 weeks postoperative, however no studies reported significant differences after 6 months. Only one of six studies reported significantly greater flexion, extension, and pronation in the PQ-P group. One of four studies reported greater radial deviation in the PQ-P group, while there were no differences in supination or ulnar deviation. One of ten and one of six studies reported greater volar tilt and ulnar variance or radial length, respectively, in the PQ-P group.
Conclusion: There is not sufficient evidence supporting the utility of PQ-P approaches over conventional PQ-D approaches for volar plate fixation of DRFs, especially at long-term follow-ups (3+ months). There may be short term benefits with PQ-P approaches, specifically with regards to PROMs in the short-term (< 6 weeks), however there is limited high-quality evidence supporting these findings.
Level of Evidence: Level III.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)
Databáze: MEDLINE
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