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https://www.readbyqxmd.com/read/30325836/distal-radius-fractures-in-the-elderly-use-of-the-volar-bearing-plate
#1
Jonathan E Miller, Aparajit Naram, BaiJing Qin, Douglas M Rothkopf
BACKGROUND: Distal radius fractures represent some of the most common injuries to the upper extremity, yet current evidence demonstrates great variability in the management of this injury. Elderly patients, in particular, stand to benefit from the early mobilization provided by operative fixation with a volar bearing plate. METHODS: We conducted a retrospective chart review on all patients 65 years or older who underwent unilateral open reduction internal fixation of distal radius fractures using a volar bearing plate at a single institution between January 2014 and January 2016...
October 15, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/30287101/absence-of-the-pronator-quadratus-muscle-precluding-distal-nerve-transfer
#2
Christopher J Dy, David M Brogan, Berdale S Colorado
The branch of the anterior interosseous nerve to the pronator quadratus (PQ) is increasingly used as a donor nerve for end-to-end and reverse end-to-side nerve transfers. The anatomy of the PQ (and its nerve branch) is generally considered reliable in the absence of prior trauma. In this report, we describe a patient with an absent PQ despite intact clinical examination of other muscles supplied by the anterior interosseous nerve. The absence of the PQ precluded the use of its nerve as a donor nerve for transfer...
October 1, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/30241975/sonographic-findings-are-associated-with-carpal-tunnel-symptom-severity
#3
Lauren Elisabeth Wessel, Danielle Christine Marshall, Jeffrey Gei-Hun Stepan, Hayley Anne Sacks, Ogonna Kenechi Nwawka, Theodore T Miller, Duretti Teferi Fufa
PURPOSE: The purpose of this study was to identify associations between the clinical manifestations of carpal tunnel syndrome (CTS) and the sonographic measurements of the median nerve in the carpal tunnel. We hypothesized that sonographic changes in the median nerve from proximal to distal along the carpal tunnel would be associated with symptom severity scores. METHODS: We report on 38 patients with clinical signs and symptoms of CTS in a prospective investigation...
September 18, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/30216783/patterns-of-upper-limb-muscle-activation-in-children-with-unilateral-spastic-cerebral-palsy-variability-and-detection-of-deviations
#4
Aurélie Sarcher, Sylvain Brochard, François Hug, Guy Letellier, Maxime Raison, Brigitte Perrouin-Verbe, Morgan Sangeux, Raphaël Gross
BACKGROUND: The aim of this study was two-fold: (1) to quantify the variability of upper limb electromyographic patterns during elbow movements in typically developing children and children with unilateral spastic cerebral palsy, and to compare different amplitude normalization methods; (2) to develop a method using this variability to detect (a) deviations in the patterns of a child with unilateral spastic cerebral palsy from the average patterns of typically developing children, and (b) changes after treatment to reduce muscle activation...
September 5, 2018: Clinical Biomechanics
https://www.readbyqxmd.com/read/30062458/pronator-quadratus-repair-with-a-part-of-the-brachioradialis-muscle-insertion-in-volar-plate-fixation-of-distal-radius-fractures-a-prospective-randomised-trial
#5
Bernd Hohendorff, C Knappwerth, J Franke, L P Müller, C Ries
INTRODUCTION: Stable pronator quadratus repair following volar plate fixation of distal radius fractures with complete plate coverage is difficult. MATERIALS AND METHODS: This study compares a modified pronator quadratus repair technique involving the brachioradialis muscle insertion (test group) with a conventional radial incision through the muscle without pronator quadratus repair (standard group). This prospective randomised study included 16 patients in the test group and 12 in the standard group; all were available for clinical, radiographic and ultrasound examination at a mean follow-up of 15 months...
October 2018: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/30003811/assessment-of-pronator-quadratus-repair-integrity-using-dynamic-ultrasonography-following-volar-plate-fixation-for-distal-radius-fractures
#6
Richard M Hinds, Nicole Montero-Lopez, Kenneth Brock, Ronald Adler, Anthony Sapienza, John T Capo, Nader Paksima
BACKGROUND: Previous work evaluating the pronator quadratus (PQ) muscle following volar plate fixation (VPF) of distal radius fractures (DRF) suggests that PQ repair often fails in the postoperative period. The purpose of this investigation was to assess PQ repair integrity following VPF of DRF using dynamic musculoskeletal ultrasonography. METHODS: Twenty adult patients who underwent VPF of DRF with repair of the PQ with a minimum follow-up of 3 months underwent bilateral dynamic wrist ultrasonography...
July 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/30003340/treatment-of-distal-radius-fractures-with-locking-plates-an-update
#7
Francois Loisel, Hugo Kielwasser, Grégoire Faivre, Thomas Rondot, Séverin Rochet, Antoine Adam, Pauline Sergent, Grégoire Leclerc, Laurent Obert, Daniel Lepage
Internal fixation with volar locking plates has revolutionized the treatment of distal radius fractures. Manufacturers have introduced plate designs that closely follow the anatomy of the distal radius. However, use of volar plates has also led to the emergence of new types of complications. While the use of monoaxial or polyaxial locking screws and of minimally invasive techniques (arthroscopy, preservation of pronator quadratus) increases the cost of the surgical procedure, it results in a tangible benefit for patients, allowing them to move their wrist almost immediately after surgery and to quickly regain their autonomy...
July 12, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29869685/-anatomy-and-biomechanics-of-the-distal-radioulnar-joint
#8
REVIEW
C K Spies, M Langer, L P Müller, J Oppermann, S Löw, F Unglaub
BACKGROUND: The functionality of the upper extremity is decisively based on rotation of the forearm. The rotation depends on the extent of motion of the distal radioulnar joint. Rotation enables complete and focused usability of the hand in order to cope with daily activities. The configuration of the distal radioulnar joint has developed over millions of years of evolution. ANATOMIC CONDITIONS: The triangular fibrocartilage complex is the crucial stabiliser of the latter joint since osseous structures are limited...
August 2018: Der Orthopäde
https://www.readbyqxmd.com/read/29655367/biologic-plating-of-unstable-distal-radial-fractures
#9
Jae-Man Kwak, Gu-Hee Jung
BACKGROUND: Volar locking plating through the flexor carpi radialis is a well-established technique for treating unstable distal radial fractures, with few reported complications. In certain circumstances, including metaphyseal comminuted fractures, bridge plating through a pronator quadratus (PQ)-sparing approach may be required to preserve the soft tissue envelope. This study describes our prospective experience with bridge plating through indirect reduction. METHODS: Thirty-three wrists (four 23A2, six 23A3, 15 23C1, and eight 23C2) underwent bridge plating through a PQ-sparing approach with indirect reduction from June 2006 to December 2010...
April 14, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29650375/vascularized-distal-radius-bone-graft-for-treatment-of-ulnar-nonunion
#10
REVIEW
Ezequiel Ernesto Zaidenberg, Ezequiel Martinez, Carlos Rodolfo Zaidenberg
Various methods have been reported to treat forearm nonunions with good results. However, in the presence of infection, inadequate vascularity of surrounding tissues, or failed prior grafts, vascularized bone grafts are a valid alternative. We describe the surgical technique to obtain distal radius vascularized bone graft pedicled on the radial artery (RA) and its clinical application in 1 case of an ulnar nonunion. We studied the surgical technique in 12 freshly injected cadavers. In the distal forearm, the RA provides several periosteal branches to supply the distal radius metaphysis...
July 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29567086/ultrasonographic-evaluation-of-the-distance-between-the-flexor-pollicis-longus-tendon-and-volar-prominence-of-the-plate-as-a-function-of-volar-plate-positioning-and-pronator-quadratus-repair-a-cadaver-study
#11
C K Goorens, K Van Royen, S Grijseels, S Provyn, J De Mey, T Scheerlinck, J F Goubau
Flexor tendon injury after volar plating of distal radius fractures is due to friction against the plate. To assess this risk, the distance between the flexor pollicis longus (FPL) and the volar prominence of the plate was measured with ultrasonography under various conditions: a standard plate fixed proximal or distal to the watershed line and a low-profile volar rim plate, with and without transection of the pronator quadratus (PQ). Distance from the FPL to the volar prominence of the plate decreased significantly when the PQ was cut and when a standard plate was placed distal to the watershed line, with the tendon often bulging over the plate...
June 2018: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/29486669/ultrasonographic-movement-of-the-flexor-pollicis-longus-tendon-before-and-after-removal-of-a-volar-plate-for-the-distal-radius-fracture
#12
Mitsuhiko Nanno, Norie Kodera, Yuji Tomori, Shinro Takai
INTRODUCTION: The purpose of this study was to compare the movement of the flexor pollicis longus (FPL) tendon on the distal radius during wrist and finger motions before and after removal of a volar plate in patients with distal radius fractures using transverse ultrasound and to evaluate the kinematic effects on the FPL by the removal. METHODS: Twenty-five patients with distal radius fracture were evaluated quantitatively by transverse ultrasound using coordinates for the movement of the FPL on the distal radius during wrist and finger motions before and after the plate removal...
January 2018: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/29368237/the-minimally-invasive-flexor-carpi-radialis-approach-a-new-perspective-for-distal-radius-fractures
#13
Yuka Igeta, Paul Vernet, Sybille Facca, Ismaël Naroura, Juan José Hidalgo Diaz, Philippe A Liverneaux
The minimally invasive flexor carpi radialis approach can be used for volar locking plate fixation of distal radius fractures. After 15-mm incision on the lateral aspect of the FCR tendon and all structures but the radial artery are reclined ulnarly, a plate is inserted under the pronator quadratus just proximal to the "watershed line." The distal epiphyseal screws are put in place, and the proximal part of the plate is exposed by flexion of the wrist to put in place the proximal screws. No drainage or postoperative immobilization is used...
January 24, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29305049/muscle-activity-during-maximal-isometric-forearm-rotation-using-a-power-grip
#14
Joseph Bader, Michael R Boland, Desney Greybe, Arthur Nitz, Timothy Uhl, David Pienkowski
This study aimed to provide quantitative activation data for muscles of the forearm during pronation and supination while using a power grip. Electromyographic data was collected from 15 forearm muscles in 11 subjects while they performed maximal isometric pronating and supinating efforts in nine positions of forearm rotation. Biceps brachii was the only muscle with substantial activation in only one effort direction. It was significantly more active when supinating (µ = 52.1%, SD = 17.5%) than pronating (µ = 5...
February 8, 2018: Journal of Biomechanics
https://www.readbyqxmd.com/read/29231799/the-minimally-invasive-approach-for-distal-radius-fractures-and-malunions
#15
Philippe A Liverneaux
This article reviews the author's currently used minimal invasive approach for volar plating of distal radius fractures. A single longitudinal incision of 1.5 cm is drawn on the lateral aspect of the flexor carpi radialis tendon in order to insert a plate under the pronator quadratus. With the wrist flexed, the plate is applied on the anterior cortex of the radius to reduce the fracture. This approach offers the advantage of preserving ligamentotaxis, which facilitates the reduction, and the small scar improves the cosmetics...
February 2018: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/29163658/shear-wave-elastography-in-the-pronator-quadratus-muscle-following-distal-radial-fracture-fixation-a-feasibility-study-comparing-the-operated-versus-nonoperated-sides
#16
Christopher J Burke, James S Babb, Ronald S Adler
The aim of this study was to assess changes in shear wave velocity within the pronator quadratus muscle in patients following volar plate fixation for distal radial fractures compared to the contralateral nonoperated side. Shear wave velocity values were obtained in the short and long axis of the pronator quadratus muscle, which were analyzed separately. Patients were also stratified by age below or above 66 years. Statistical analysis was performed using paired sample Wilcoxon signed rank and t tests. Pearson and Spearman rank correlations were also used...
November 2017: Ultrasound: Journal of the British Medical Ultrasound Society
https://www.readbyqxmd.com/read/29101976/repair-of-pronator-quadratus-with-partial-muscle-split-and-distal-transfer-for-volar-plating-of-distal-radius-fractures
#17
REVIEW
Hui-Kuang Huang, Jung-Pan Wang, Ming-Chau Chang
Flexor tendon injury is a rare, but serious, complication after volar plate fixation for distal radius fractures. The plate position and prominence at the watershed line are contributing factors that cause flexor tendon injury. With the standard volar approach, the pronator quadratus (PQ) is typically elevated off the radial attachment. The distal part of the plate is often visible after repair of the PQ. We describe a "PQ-splitting" technique for covering the distal edge of the plate if primary PQ repair cannot completely cover the distal part of the plate...
November 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29098069/reliability-of-the-pronator-quadratus-fat-pad-sign-to-predict-the-severity-of-distal-radius-fractures
#18
Julia Loesaus, Isabel Wobbe, Erik Stahlberg, Joerg Barkhausen, Jan Peter Goltz
AIM: To evaluate the reliability of pronator quadratus fat pad sign to detect distal radius fracture and to predict its severity. METHODS: Retrospectively we identified 89 consecutive patients (41 female, mean age 49 ± 18 years) who had X-ray (CR) and computed tomography (CT) within 24 h following distal forearm trauma. Thickness of pronator quadratus fat pad complex (PQC) was measured using lateral views (CR) and sagittal reconstructions (CT). Pearson's test was used to determine the correlation of the PQC thickness in CR and CT...
September 28, 2017: World Journal of Radiology
https://www.readbyqxmd.com/read/28736099/selective-anterior-interosseous-nerve-conduction-study-coaxial-needle-versus-surface-electrode-recordings
#19
Paul Seror
OBJECTIVES: The aim is to determine which method provides the most selective motor nerve conduction of the anterior interosseous nerve (AIN), when the stimulation cannot be restricted to this nerve. METHODS: The AIN was stimulated at the elbow, along with the whole median nerve. The motor action potential (MAP) of the AIN was recorded with 2 different methods: 1 - a coaxial needle inserted in the pronator quadratus muscle (PQ); 2 - a pair of surface electrodes fixed on the PQ...
September 2017: Neurophysiologie Clinique, Clinical Neurophysiology
https://www.readbyqxmd.com/read/28725505/long-volar-plating-for-metadiaphyseal-fractures-of-distal-radius-study-comparing-minimally-invasive-plate-osteosynthesis-versus-conventional-approach
#20
Emilie Pire, Juan José Hidalgo Diaz, Santiago Salazar Botero, Sybille Facca, Philippe A Liverneaux
Background  Minimally invasive plate osteosynthesis (MIPO) has been used in wrist surgery for several years. The purpose of this retrospective study was to compare clinical and radiologic outcomes of MIPO technique with those of a conventional approach in the treatment of metadiaphyseal distal radius fracture by long volar plating. Materials and Methods  Our series consisted of 32 fractures in 31 patients, mean age 63.9 years, including 16 men and 15 women. MIPO technique was used in 15 wrists (group 1) and conventional approach (> 60 mm of skin incision) in 17 wrists (group 2)...
August 2017: Journal of Wrist Surgery
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