The pronator quadratus fascia is the fibrous sheath enclosing the pronator quadratus muscle at the distal forearm, forming the fibrous floor of the distal forearm compartment. The anterior interosseous nerve passes beneath this fascia.
Provides the distal forearm fibrous compartment boundary, maintains the pronator quadratus position against the distal radius and ulna, and creates the fascial interval used in volar distal radius approaches.
In volar plate fixation of distal radius fractures, the pronator quadratus is elevated from the radius by incising its fascia — this is the subperiosteal plane used in volar plate fixation. Repair of the pronator quadratus fascia at closure restores DRUJ stability and protects the flexor tendons from contact with the plate.
The PQ fascia is incised and the muscle elevated subperiosteally to expose the distal radius volar surface for plate fixation, with fascial repair at closure reducing flexor tendon irritation.
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