Objectives: The objective of this study was to compare the results of two methods for sparing the pronator quadratus in volar plating of distal radius fractures.
Methods: A total of 110 patients were randomized to volar plating with sparing of the pronator quadratus either by a transverse incision along the distal border of the pronator quadratus (Group A, 55 people) or by the brachioradialis splitting method (Group B, 55 people). The operative and radiation time, range of motion, grip strength, Disabilities of the Arm, Shoulder, and Hand (DASH) scores, Visual Analog Scale (VAS) scores, and complications were recorded.
Results: There were no significant differences in the mean operative time, radiation time, mean bone union time, or total complication rate between the groups. We found no significant differences in range of motion, grip strength, VAS scores, and DASH scores at any of the study intervals between the groups. Although neurapraxia of the superficial branch of the radial nerve was more common in Group B than in Group A (6.7% vs. 0%), the difference was not significant.
Conclusions: Both methods were efficient approaches for sparing the pronator quadratus and had similar clinical outcomes, but they had different indications.
Keywords: Distal radius fractures; muscle sparing; outcomes; pronator quadratus; volar plating; wrist fractures.