Abstract
Background Open injuries communicating with the wrist joint are essential to detect to facilitate
timely, appropriate treatment. While the saline load test to detect traumatic arthrotomy
has been well studied in the knee and ankle, it has not been studied in the wrist,
and therefore the appropriate volume of saline infusion to detect traumatic arthrotomy
is not known.
Purpose The purpose of this study was to utilize wrist arthroscopy to determine the saline
infusion volume necessary to achieve 99% sensitivity in detecting traumatic arthrotomy.
Methods Twenty consecutive patients undergoing elective wrist arthroscopy were prospectively
enrolled. A 5-mm arthrotomy was established between the third and fourth dorsal extensor
compartments. An 18-gauge needle was inserted into the 6R portal on the radial side
of the extensor carpi ulnaris. Sterile normal saline was injected into the wrist joint
through the needle at a rate of 0.1 mL per second until extravasation from the 3–4
portal was visualized. Saline volumes required for extravasation were analyzed.
Results The mean saline volume required for extravasation was 0.8 mL. The volume of saline
needed to achieve sensitivities of 50, 90, 95, and 99% were 0.4, 2.2, 2.3, and 2.5
mL respectively.
Conclusions The saline infusion volume required to detect a dorsal radiocarpal arthrotomy with
99% sensitivity was 2.5 mL. We recommend using at least 2.5 mL when performing the
saline load test to rule out a potential arthrotomy to the wrist in the traumatic
setting.
Level of Evidence: This is a Level II, diagnostic study.
Keywords
arthrotomy - saline load test - wrist
