This study aims to compare the outcomes of Volar locking plating (VLP) versus percutaneous Kirschner wires (K-wire) fixation for surgical management of distal radius fractures.

We systematically searched multiple databases, including MEDLINE for randomized controlled trials (RCTs) comparing outcomes of VLP fixation and K-wire for treatment of distal radius fracture in adults. The methodological quality of each study was assessed by the Cochrane Risk of Bias tool. Patient-reported outcomes, functional outcomes, and complications at 1 year follow up were evaluated. Meta-analysis was performed using random-effects models and results presented as risk ratios (RRs) or mean differences (MDs) with 95% confidence interval (CI).

13 RCTs with 1336 participants met the inclusion criteria. Disabilities of the Arm, Shoulder and Hand (DASH) scores were significantly better for VLP fixation (MD= 2.15; 95% CI, 0.56-3.74; P = 0.01; I2=23%). No significant difference between the two procedures for grip strength measured in kilograms (MD= −3.84; 95% CI,-8.42-0.74; P = 0.10; I2=52%) and Patient-Rated Wrist Evaluation (PRWE) scores (MD= −0.06; 95% CI,-0.87-0.75; P = 0.89; I2=0%). K-wire treatment yielded significantly improved extension (MD= −4.30; P=0.04) but with no differences in flexion, pronation, supination, and radial deviation (P >0.05). The risk of complications and rate of reoperation were similar for the two procedures (P >0.05).

This meta-analysis suggests that VLP fixation improves DASH score at 12 months follow up, however, the difference is small and unlikely to be clinically important. Existing literature does not provide sufficient evidence to demonstrate the superiority of either VLP or K-wire treatment in terms of patient-reported outcomes, functional outcomes, and complications.

We report an unusual case of knee disease where calcific tendonitis occurring in both quadriceps and patellar tendon simultaneously in the same knee. A 47 year old female presented to orthopaedics outpatient clinic with acute onset of swelling and knee pain with no history of trauma. She was found to have a moderate effusion of the knee joint with mild tenderness over the mid quadriceps tendon. Active flexion of the knee joint was painful with a range of motion between 0-90 degrees. She is otherwise healthy with no past medical history. Plain radiographs and Magnetic Resonance Imaging (MRI) Scan revealed calcification of both tendons.

Calcific tendonitis is classically found in the supraspinatus tendon of the shoulder. In addition, it has been described in other areas of the body such as the wrist, thigh, hip, knee and ankle. This condition usually occurs in the quadriceps or patellar tendons separately and rarely affecting both tendons in the same knee simultaneously. The patients condition improved significantly with physiotherapy, anti-inflammatory medications and ultrasound therapy.

Calcific tendinitis of both quadriceps and patellar tendon is a very rare cause of knee pain. Most of the time it is treated conservatively with non-steroidal anti-inflammatory drugs and ultrasound therapy and some times steroid injection. However; patient may require surgical intervention especially in refractory cases to resolve the condition.