• Tyler D Kupchick, Matthew J Yousif, Alexander J Colen, Blake R Fenkell, and Alfred M Faulkner.
• Department of Orthopaedic Surgery, Beaumont Farmington Hills, Farmington Hills, MI, USA. Electronic address: tyler.kupchick@beaumont.org.
• J Shoulder Elbow Surg. 2020 Sep 1; 29 (9): 1869-1875.

BackgroundTraumatic elbow arthrotomies are common injuries evaluated for by orthopedic services; however, failed identification of a traumatic arthrotomy leads to a high risk of developing septic arthritis. Currently these injuries are evaluated by either a saline load test or a computed tomography (CT) scan, yet there is little published evidence regarding detection of traumatic elbow arthrotomies.HypothesisIn our study, we hypothesized better sensitivity and specificity of detecting a traumatic elbow arthrotomy with a CT scan over a saline load test.Study DesignDescriptive cadaveric laboratory study.MethodsTen fresh-frozen cadaveric transhumeral upper extremity amputation specimens were thawed for trial. Specimens were brought through CT scan prior to arthrotomy, arthrotomy was made, and then post arthrotomy a repeat CT scan was performed. A saline load test was then performed after all CT scans were completed.ResultsZero CT scans before (0/10) and after (0/10) the arthrotomies were positive for intra-articular air in the elbow joint with a 0% sensitivity and specificity. The saline load test had an average positive test at 19 mL with a 100% sensitivity and 100% specificity.ConclusionAfter our study and based on the recommendations of the brief literature on this topic, we advise evaluating for traumatic elbow arthrotomies with a saline load test as the primary method of detection.Published by Elsevier Inc.

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