Pronator quadratus repair using the Henry approach with an outward-return running suture

Repair of the quadratus pronator after osteosynthesis of the distal radius via the Henry approach is generally considered a difficult procedure. The quadratus pronator is a powerful muscle which stabilizes the distal radioulnar joint. The muscle is most often injured in association with distal fracture of the radius. Apposition osteosynthesis appears to be the most appropriate procedure in order to limit loss of reduction, i.e. distal radioular variance, observed in the first postoperative weeks. Tendon complications observed with dorsal approaches and the development of new volar plates with locking screws have offered new prospects for the Henry approach. We propose here a technique for repairing the pronator quadratus with an outward-return running suture using a 2.0 single-strand thread. The technique is designed to redistribute tension along the muscle borders progressively and precisely. Muscle integrity can thus be restored and the flexor system is isolated from the osteosynthesis material.