A randomized controlled trial on management of distal radius fractures with plating followed by pronator quadratus repair versus no repair in a tertiary care hospital in Andhra Pradesh, India
Journal Title: Medpulse International Journal of Orthopedics - Year 2019, Vol 10, Issue 1
Abstract
Background: Among all the fractures of upper limbs, distal radial fractures are one of the most common in adults in India and also one of the commonest fractures encountered in orthopaedic clinical practice. Several methods of treatment have been suggested for these fractures. However, controversies about the best treatment approach still exist. This study is an attempt to evaluate the functional outcome of surgical treatment of distal radius fractures by volar plating followed by complete repair of PQ versus no repair. It was a RCT conducted among 72 patients (36 with PQ repair and 36 with no PQ repair). Results: The age in years ranged from 24 to 60 years. The mean age was 47.4 years. There were 50 (69.44%) females and 22 (30.56%) males. Group A (Subjected to Pronatus Quadratus repair) had 36 patients with mean age of 45.23 years and included 24(66.7%) females and 12 (33.3%) males, whereas Group B (Not subjected to pronatus quadrates repair) had 36 patients with a mean age of 47.64 years and included 26 (72.2%) females and 10 (27.8%) males. With regard to ROM, at 6 weeks post–operatively, PS arc showed significant improvement in Group A compared to Group B (t = 2.022, P = 0.047) while at 12 weeks post – operatively, EF arc showed significant improvement in Group B compared to Group A (t = 2.551, P = 0.013). About Quick DASH scores, a statistically significant difference was seen between group A and group B at 6 weeks (t 3.375 p = 0.001) and 12 weeks (t 3.008 p = 0.004). About the Mayo-Wrist-Score, both groups showed satisfying results after 6 weeks and values improved in both groups at 12 weeks. But, no significant differences found between groups (t = 0.240, p = 0.811 at 6 weeks; t = 0.641, p = 0.524 at 12 weeks). Though, a significant reduction of pain was found in group A (Chi square = 4.645, p = 0.031 at 6 weeks postoperatively, no significant difference could be seen (Chi square = 0.061, p = 0.806) between groups at 12-weeks post operatively. Conclusions: Repair of PQ muscle could be considered as an attempt for improved outcome following volar plating in distal radius fractures. More studies in large samples and different settings are to be conducted to provide further evidence for confirmation of the results.
Authors and Affiliations
Rajasekhar Rao G, Nageswara Rao V, Lavanya K M, Sujith Kumar V
Keywords
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- EP ID EP590577
- DOI 10.26611/10201012
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