The Effects Of Repair Pronator Quadratus After Distal Radius Fractures: A Systematic Review And Meta-analysis

Objective: To systematically review the efficacy of pronator quadratus repair versus no repair after volar plate fixation in the distal radius fractures.Methods: A systematic search was conducted in Cochrane Library?Embase ? MEDLINE ? Pubmed ? WanFang Database,VIP,CNKI and Chinese Biomedical Database from inception to December 2018.All randomized controlled trials(RCTs)and cohort studies comparing pronator quadratus repair with no repair in distal radius fractures were included.Two reviewers independently screened literature,extracted data and assessed the risk of bias of included studies,then,meta-analysis was performed by using RevMan 5.3 software.If lack of enough included studies,the systematic review was performed.Results:A total of 642 patients in 8 studies were included(78 patients were to lost follow-up),of which 303 underwent pronator quadratus repair,while 261 patients underwent no repair.The results of meta-analysis indicated that there were no statistically significant differences inDASH-scores[MD=0.89,95%CI(-1.21,2.99),P=0.41] at post-operative12 months ? pronation of wrist at post-operative 6 months[MD=1.41,95%CI(-1.05,3.87),P=0.26]?supination of wrist at post-operative 6months[MD=0.07,95%CI(-2.80,2.93),P=0.96]?supination of wrist at least post-operative 6 months[MD=1.32,95%CI(-0.34,2.97),P=0.12]?complication rates [RR=0.53,95%CI(0.23,1.22),P=0.14] between two groups.Moreover,qualitative analysis showed that there were no significant differences in largely DASH score,VAS score,range of motion and complication rates between the two groups(P>0.05).Conclusion:We found that repair of pronator quadratus had no significant effect on medium and long-term wrist function after volar plate fixation in distal radius fractures.However,due to the limitations of this paper,this conclusion needs to be verified by more high-quality studies in the future.