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Wrist Arthrotomy Saline Load Test.

Joseph P Scollan¹, Morad Chughtai¹, Jessica L Churchill¹

¹Cleveland Clinic Foundation, OH, USA.

Hand (New York, N.Y.)

|March 28, 2022

Summary

This summary is machine-generated.

The saline load test can identify traumatic wrist arthrotomies. Using a minimum of 3.1 mL of saline offers high sensitivity for diagnosing these injuries, preventing serious complications.

Keywords:

anatomy diagnosis fracture/dislocation radiocarpal specialty surgery trauma wrist

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Area of Science:

Orthopedic Surgery
Diagnostic Imaging
Cadaveric Research

Background:

Traumatic wrist arthrotomy can lead to septic arthritis if missed.
The saline load test is used for other joints but lacks optimization for the wrist.

Purpose of the Study:

To investigate and optimize the saline load test for identifying traumatic wrist arthrotomies.

Main Methods:

A cadaveric study involving 15 wrists with created traumatic arthrotomies.
Methylene blue dyed saline was injected into the wrist via the 1-2 portal.
The volume of saline required for extravasation from the arthrotomy site was recorded.

Main Results:

The mean saline volume to identify arthrotomy was 1.22 mL (range, 0.1-3.1 mL).
Greater joint range of motion correlated with higher saline volume needed for extravasation (OR: 1.049, P = .003).
Cadaver age, laterality, and extension range of motion were not significant factors.

Conclusions:

2.68 mL and 3.02 mL of saline provided 95% and 99% sensitivity for diagnosing traumatic wrist arthrotomy, respectively.
A minimum of 3.1 mL saline is recommended for evaluating traumatic wrist arthrotomy.