Does the saline load test still have a role in the orthopaedic world? A systematic review of the literature
| Autor: | Julio J. Jauregui, Anant Dixit, William P. Urban, Anthony V. Ventimiglia, Benjamin B. Browning, Emmanuel M. Illical |
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| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
musculoskeletal diseases
medicine.medical_specialty genetic structures medicine.medical_treatment Elbow Wounds Penetrating Wrist Sodium Chloride Injections Intra-Articular 03 medical and health sciences Arthroscopy 0302 clinical medicine lcsh:Orthopedic surgery Medicine Humans Orthopedics and Sports Medicine Range of Motion Articular Saline 030222 orthopedics medicine.diagnostic_test business.industry Knee arthrotomy 030208 emergency & critical care medicine General Medicine Evidence-based medicine lcsh:RD701-811 medicine.anatomical_structure Tomography x ray computed Saline load test knee arthrotomy joint arthrotomy traumatic joint injury Traumatic joint injury Physical therapy Surgery Joints Original Article Level ii Ankle business Tomography X-Ray Computed Joint arthrotomy |
| Zdroj: | Acta Orthopaedica et Traumatologica Turcica, Vol 50, Iss 6, Pp 597-600 (2016) Acta Orthopaedica et Traumatologica Turcica Volume: 0, Issue: 0 |
| ISSN: | 1017-995X |
| Popis: | Introduction: Periarticular injuries are important to evaluate as joint penetration may result in septic arthritis. Although the gold-standard to evaluate the integrity of the joint capsule is surgical exploration, this requires extensive operative resources and is costly. Saline Load Tests (SLTs) have consequently been used in emergent settings to evaluate extension of periarticular wounds into capsule. Since no study has comprehensively evaluated the ability of SLT to detect open wound injuries within different joints, we systematically evaluated all literature. Methods: We systematically evaluated the accuracy of the SLT in diagnosing penetrating joint injuries in the elbow, wrist, shoulder, knee, or ankle utilizing specific inclusion/exclusion criteria. Results: The SLT values to determine knee arthrotomies vary from 73.8 mL to 194 mL with sensitivities ranging from 91%-99% depending on the size of the laceration. A SLT of 30 mLs in the ankle yields sensitivities ranging from 95-99% in assessing joint penetration. A SLT of 45 mL in the elbow yields a sensitivity of 95% in assessing joint penetration. The addition of methylene blue does not change the sensitivity of the SLT. Conclusion: Penetrating joint injuries require prompt diagnosis to avoid deleterious sequelae. Several groups have demonstrated the utility of the SLT as a diagnostic modality for such injuries. However, the literature analyzed in this study was inconclusive and more studies are required to make definitive recommendations. In addition, more studies will be needed on joints other than the knee, pediatric patients, and the use of methylene blue dye in conjunction with SLT. DOI: 10.3944/AOTT.2016.15.0398This abstract belongs to the un-edited version of the article and is only for informative purposes. Published version may differ from the current version. |
| Databáze: | OpenAIRE |
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