gms | German Medical Science

Objectives/Interrogation: To evaluate the prevalence of flexor carpi radialis brevis (FCRB) in patients with volar wrist plating done for fracture distal radius in Chinese population

Methods: This is a retrospective single-centre study. In a 3.5-year period from March 2015 to August 2018, 133 patients who suffered from distal radius fracture requiring volar locking plate fixation were recruited. Patients younger than 18 years old were excluded. Non-Chinese patients were excluded.

All data were retrieved from electronic clinical data analysis and reporting system in our hospital. Descriptions in operation records were collected.

All operations were carried out by or supervised by hand specialists. A direct flexor carpi radialis (FCR) approach was used. FCR tendon sheath was incised. FCR and flexor pollicis longus were retracted ulnarly. Pronator quadratus was subperiosteally elevated with an L-shaped incision to expose the underlying distal radius.

All subjects were followed-up in out-patient clinic for at least 3 months. Any complications were recorded.

Results and Conclusions: 133 patients with volar wrist plating performed were identified. 9 patients with FCRB variant were identified (6.8%). 7 were female patients and 2 were male patients. All cases were asymptomatic before the occurrence of the fracture. During surgical dissection, the FCRB were noted to be originated from the volar aspect of the distal third of the radius, occupying part of the radial border of pronator quadratus. The pronator quadratus were hypoplastic. The insertion of FCRB were beyond the surgical exposure of distal radius fracture fixation. No complications were noted during follow up at 3 months.

Literatures on the prevalence of FCRB were scarce. Studies from Japan, Singapore and Brazil reported the prevalence to be 1.6-8.7%. Our series was the first study showing 6.8% prevalence of FCRB in Chinese population with volar locking plate surgery performed.

Although most patients with FCRB variant were asymptomatic, symptomatic cases such as tendinopathy, partial tear, painful forearm mass and intersection syndrome were reported.

In conclusion, in Chinese population with volar locking plate done for distal radius fracture, the prevalence of FCRB was 6.8%.

As volar locked plating is a common way of treating distal radius fracture, knowledge of distal forearm anatomy and the possible variant is important. Surgeons should be aware of such possibility to avoid neurovascular injury in these patients.