RESUMO
Background The saline load test has not been well explored in the elbow. We aimed to determine 1) the saline infusion volume needed for 90%, 95%, and 99% sensitivity in detecting elbow arthrotomy; and 2) factors associated with higher volume at detection using sixteen forequarter upper extremity amputation cadavers. Methods Sixteen fresh-frozen forequarter upper extremity amputations were procured, and demographic data, including age, body mass index (BMI), and laterality, were recorded. The olecranon process, radial head, and the lateral epicondyle were palpated, and elbow arthrotomy was consistently performed at the direct lateral arthroscopic portal site. The elbow joint was loaded with saline mixed with methylene blue (concentration: 2 mg/300 mL) using an 18-gauge needle inserted just medial to the triceps tendon 2 cm superior to the olecranon. Results Mean volume for extravasation was 12.2 mL ±6.26. Volume needed for 90%, 95%, and 99% sensitivities were 21 mL, 23 mL, and 25.4 mL. Linear regression demonstrated that increasing age was associated with lower volume to extravasation (OR: 0.67; 95% CI: 0.48-0.932; p=0.037), while BMI (p=0.571) and extremity laterality (p=0.747) did not affect the volume. Conclusions The saline load test can be effective in diagnosing the violation of the elbow joint in traumatic injuries. This test should be used in conjunction with the clinical examination and radiographs before operative decisions are made. We recommend using ≥26 mL to rule out traumatic elbow arthrotomy.
RESUMO
BACKGROUND: Bennett lesions represent an extra-articular ossification on the posteroinferior aspect of the glenoid fossa and a potential source of posterior shoulder pain and limitation. The prevalence of Bennett lesions in the general population is unknown. MATERIALS AND METHODS: A total of 5,662 scapulae from 2,831 individual cadaveric specimens greater than 18 years of age at the time of death were examined. Matching scapulae were evaluated for Bennett lesions by two independent authors. Lesion prevalence was calculated and statistical analysis performed to evaluate differences in prevalence based on specimen sex (males vs. females), ancestry (African-American vs. Caucasian) and with increasing age at the time of death. RESULTS: Bennett lesions were observed in 3.5% (n = 98 of 2,831) of specimens and 1.8% (n = 104 of 5,662) of scapulae. Interobserver reliability was 0.83, indicating excellent agreement among authors. Males possessed significant higher odds of possessing a Bennett lesion when compared to females (p = .009) and African-American specimens when compared to Caucasian specimens (p < .001). Each additional year of age was associated with a 1.4% increase in odds of a specimen having a Bennett lesion, while no significant increase in Bennett lesion prevalence was appreciated with increasing specimen age at the time of death when comparing male to female specimens (p = .07) or African-American to Caucasian specimens (p = .73). CONCLUSIONS: Bennett lesions were identified in 3.5% of osseous specimens and 1.8% of scapulae, with significantly higher prevalence in male and African-American specimens.