Role of the Pronator Quadratus in Distal Radius Fractures

NCT03371030 | Completed

• 1 other identifier: IIBSP-QUA-2017-36
• Study Type: interventional
• Target: 100
• Locations: 1 country
• Sites: 1

Brief Summary

The skin, the bones, and most muscles received branches from the source arteries of at least two angiosomes, thus revealing one of the important anastomotic pathways by which the circulation is reconstituted in those cases where a source artery is interrupted by disease or trauma. There are numerous metaphyseal-epiphyseal branches arise within the pronator quadratus and the anterior interosseous artery and course towards the distal radius. These branches may be fundamental to the healing of the distal radius fractures and make nonunion a rare complication. The aim of this study is the evaluation of the role of the pronator quadratus muscle and its repair in volar approach in distal radius fractures treated with plate fixation.

Conditions

Radius; Fracture, Lower or Distal End

Keywords

distal radius fractures; pronator quadratus; osteosynthesis

Outcome Measures

Primary Outcomes (1)

• Fracture consolidation

  X-Ray radius union

  3 months

Secondary Outcomes (2)

• Clinical stability

  3 months

• Radiological stability

  3 months

Study Arms (2)

Pronator quadratus reparation

EXPERIMENTAL

Surgical Intervention: Radius fracture teated with plate and pronator quadratus muscle repair.

Procedure: Pronatus quadratus reparation

No pronator quadratus reparation

ACTIVE COMPARATOR

Surgical Intervention: Radius fracture with plate without pronator quadratus muscle repair.

Procedure: Pronatus quadratus reparation

Interventions

Pronatus quadratus reparation PROCEDURE

Displaced and intra-articular distal radius fractures treated with volar approach and plate fixation. Pronator Quadratus muscle repair.

No pronator quadratus reparation; Pronator quadratus reparation

Eligibility Criteria

• Age: 18 Years - 90 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Distal radius fractures with intra-articular fragment, comminuted or displaced fracture
• Adults between 18- 90 years old

You may not qualify if:

• Children
• Non displaced distal radius fractures treated with immobilization.
• Adults older than 90 years old

Sponsors & Collaborators

• Fundació Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau: lead
• Spanish Clinical Research Network - SCReN: collaborator

Study Sites (1)

Hospital de la Santa Creu i Sant Pau

Barcelona, 08025, Spain

Location

Related Publications (7)

• Haerle M, Schaller HE, Mathoulin C. Vascular anatomy of the palmar surfaces of the distal radius and ulna: its relevance to pedicled bone grafts at the distal palmar forearm. J Hand Surg Br. 2003 Apr;28(2):131-6. doi: 10.1016/s0266-7681(02)00279-6.

  PMID: 12631484 BACKGROUND

• Inoue Y, Taylor GI. The angiosomes of the forearm: anatomic study and clinical implications. Plast Reconstr Surg. 1996 Aug;98(2):195-210. doi: 10.1097/00006534-199608000-00001.

  PMID: 8764707 BACKGROUND

• Orbay J, Badia A, Khoury RK, Gonzalez E, Indriago I. Volar fixed-angle fixation of distal radius fractures: the DVR plate. Tech Hand Up Extrem Surg. 2004 Sep;8(3):142-8. doi: 10.1097/01.bth.0000126570.82826.0a.

  PMID: 16518106 BACKGROUND

• Sheetz KK, Bishop AT, Berger RA. The arterial blood supply of the distal radius and ulna and its potential use in vascularized pedicled bone grafts. J Hand Surg Am. 1995 Nov;20(6):902-14. doi: 10.1016/S0363-5023(05)80136-4.

  PMID: 8583061 BACKGROUND

• Huang HK, Wang JP, Chang MC. Repair of Pronator Quadratus With Partial Muscle Split and Distal Transfer for Volar Plating of Distal Radius Fractures. J Hand Surg Am. 2017 Nov;42(11):935.e1-935.e5. doi: 10.1016/j.jhsa.2017.08.018.

  PMID: 29101976 BACKGROUND

• Lamas C, Llusa M, Mendez A, Proubasta I, Carrera A, Forcada P. Intraosseous vascularity of the distal radius: anatomy and clinical implications in distal radius fractures. Hand (N Y). 2009 Dec;4(4):418-23. doi: 10.1007/s11552-009-9204-9. Epub 2009 May 28.

  PMID: 19475457 BACKGROUND

• Lamas C, Arenas J, Almenara M, Rojas R, Fa-Binefa M, Toro-Aguilera A. Is pronator quadratus muscle repair required after anterior plate fixation for distal radial fractures? A prospective randomized comparative study. J Hand Surg Eur Vol. 2024 Mar;49(3):334-340. doi: 10.1177/17531934231192337. Epub 2023 Sep 8.

  PMID: 37684023 DERIVED

MeSH Terms

Conditions

Fractures, Bone; Wrist Fractures

Condition Hierarchy (Ancestors)

Wounds and Injuries; Wrist Injuries; Arm Injuries

Study Officials

• Claudia Lamas, MD, Ph D

  Fundació Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: November 29, 2017
• First Posted: December 13, 2017
• Study Start: January 4, 2018
• Primary Completion: October 28, 2022
• Study Completion: November 30, 2022
• Last Updated: March 8, 2023

Record last verified: 2023-03

Data Sharing

• IPD Sharing: Will not share

Locations

ES (1)