The Dimensions of Pronator Quadratus and Its Neurovascular Structures – A Cadaveric Study with Its Clinical Implications in Distal Forearm Surgeries

Abstract

Introduction: The pronator quadratus is one of the deep muscles of the front of the forearm. The neurovascular supply of the muscle is derived from the anterior interosseous nerve and vessels. This muscle is approached in various surgical procedures involving the distal radius. Its nerve can be utilised as a graft in case of peripheral nerve lesions and the anterior interosseous artery perforator flap is used for wrist and hand surgeries. Hence, the anatomy of the muscle and its neurovascular pedicle is needed in orthopedic surgeries. Materials and Methods: In this study, 84 upper limbs from 24 male and 18 female cadavers, age ranging from 55 to 78 years, were dissected to study the pronator quadratus muscle and its neurovascular supply in the Department of Anatomy, Sri Manakula Vinayagar Medical College and Hospital, Pondicherry. Various levels of measurements regarding the length and width of the muscle were considered. The number of branches of its neurovascular structures and their levels of entry into the muscle from various landmarks was measured. The Student t-test was applied to identify the P-value regarding the difference between the subjects. Results: No significant differences were observed regarding the measurements of the muscle and its neurovascular structures between male and female cadavers. Conclusion: This study can be useful for the surgeries involving the lower part of front of forearm. Since no significant difference was found between the genders regarding the variables, the morphometry of the muscle and its supply can be generalised for both sexes.

Keywords

• anterior interosseous artery; anterior interosseous nerve; deep flexors of forearm; distal radius fracture; volar plating