Evaluation of the efficacy of palmar locking plate internal fixation combined with pronator quadratus protection in the treatment of distal radius fractures: A retrospective cohort study

This retrospective cohort study aimed to evaluate the efficacy of palmar locking plate internal fixation combined with pronator quadratus protection in the treatment of distal radius fractures. Patient records of individuals with distal radius fractures who underwent treatment with palmar locking plate internal fixation with (pronator quadratus protection groups, n = 65) or without (pronator quadratus incision group, n = 41) pronator quadratus protection were analyzed. Baseline characteristics, radiographic parameters at 6-week follow-up, functional outcomes at 3-month follow-up, patient-reported outcomes at 6-month follow-up, health-related quality of life at 1-year follow-up, radiographic union at 1-year follow-up, and complications at 1-year follow-up were assessed. Comparative analysis revealed superior radiographic outcomes in the Pronator Quadratus Incision group at 6-week follow-up. At 3-month follow-up, the Pronator Quadratus Incision group exhibited higher disabilities of the arm, shoulder, and hand (DASH) scores and lower grip strength compared to the Pronator Quadratus Protection group. Patient-reported outcomes at 6 months indicated higher patient satisfaction and shorter return to work duration in the Pronator Quadratus Protection group. Health-related quality of life indicators at 1-year follow-up showed higher EQ-5D scores in the Pronator Quadratus Protection group. Complications were low in both groups, with a higher incidence of nerve injuries in the Pronator Quadratus Protection group. Spearman rank correlation analysis revealed significant correlations between the adoption of Pronator Quadratus Protection and several prognostic parameters. The study revealed the comparative advantages of the outcomes of palmar locking plate internal fixation combined with pronator quadratus protection in the treatment of distal radius fractures.