Evaluation of Diagnostic Value of Saline Load Test in Penetrating Periarticular Injuries.

[摘要] Background:Lacerationaroundthejointsmaypenetratethesynovialmembranebarrierandcontaminatethejoint.Determiningthepenetrationofthesynovialmembraneisimportanttothediagnosis.Salineloadtesthasbeenusedinthepasttodiagnosispenetratingjointinjuriesbuttheefficacyandsafetyofthetesthavenotbeendetermined.Thisstudywasdesignedtoevaluateaccuracyandsafetyofthisprocedureinpenetratingperiarticularinjuries.MaterialsandMethods:BetweenApril2002tillMarch2003,100casesofPeriarticularinjuriestolargejointswithpossibilityofintraarticularextensionwerestudied.Clinicalexaminationperformedtodeterminethepossibilityofpenetratingintothepoints.Thensalineloadtestwasperformedbyinjectingappropriatequalitiesofsalineintothejoint,dependingintothesizeofjoint,watchingforextravasationsofsalinewithjointatrestandpassivemotion.Twoweekslaterpatientsexaminedinoutpatientclinicforevidenceofanycomplicationsrelatedtothetest.Result:theratioofmaletofemalewas19:1;themeanageatthetimeofinjurywas27.4.Eightytwopercentofinjurieswereduetoroadtrafficaccident,thekneewasinvolvedin68%ofcases.In47patientssalineloadtestwaspositive.In38%ofthemtheresultofclinicalexaminationhadpredictedthatthejointspacemightnotbeopentoexterior.In28%of53patientsinwhomsalineloadtestwasnegativeclinicalpredictionhadindicatedanopenjointinjury.Overall,theresultofsalineloadtesthadchangedthetreatmentplannedonthebasisofclinicalpredictionin33%ofpatients.Therewasnocomplicationrelatedtotheprocedure.Conclusion:decisionmakingtooperateornotthebasisofclinicalexaminationisriskyandcanhavedangerousconsequences.Salineloadtestisasafeandreliablemethodfordiagnosisofintraarticularpenetrationofpenetratinglacerations.

[学科分类] 基础医学

[关键词] Saline Load Test;Penetrating;Periarticular Injuries