Saline Load Test for Detecting Traumatic Arthrotomy in the Wrist

Area of Science:

• Orthopedic Surgery
• Diagnostic Imaging
• Musculoskeletal Research

Background:

• Detecting open wrist joint injuries is crucial for timely treatment.
• The saline load test is established for knee and ankle arthrotomy but not for the wrist.
• The optimal saline volume for wrist arthrotomy detection is unknown.

Purpose of the Study:

• To determine the saline infusion volume for 99% sensitivity in detecting traumatic wrist arthrotomy.
• To establish a standardized diagnostic volume for the wrist saline load test.

Main Methods:

• Prospective enrollment of 20 patients undergoing elective wrist arthroscopy.
• Creation of a 5-mm arthrotomy between dorsal extensor compartments.
• Gradual saline injection via an 18-gauge needle until extravasation, with volume recorded.

Main Results:

• The mean saline volume for extravasation was 0.8 mL.
• 2.5 mL of saline achieved 99% sensitivity in detecting arthrotomy.
• Volumes of 0.4, 2.2, and 2.3 mL provided 50%, 90%, and 95% sensitivity, respectively.

Conclusions:

• A saline infusion volume of 2.5 mL is recommended for 99% sensitivity in detecting dorsal radiocarpal arthrotomy.
• Clinicians should use at least 2.5 mL for the saline load test to rule out wrist arthrotomy.
• This study provides evidence for the diagnostic utility of the saline load test in wrist trauma.