Criteria to Date Traumas

Fig. 1

Turbidity: scale of reference (from 0 to 4); dilutions

A colourful fluid (T3–T4) testifies to a recent trauma which happened less than 2 weeks before (usual delay for hemarthroses to disappear).

A rather clear fluid (T1–T2) testifies to a trauma of less than 6 weeks old.

A transparent fluid (T0) testifies to a trauma of more than 6 weeks old.

Be careful of the variations linked to some microcrystalline or rheumatoid arthritides.

2 The Presence of Hematic Synovitis

We all noticed the presence of hematic synovitis in wrists that have just been injured. It shows the extrinsic ligamentous zone implied in the injury. It gives a real topography of the zone.

In recent traumas, less than 2 weeks old, the whole ligamentous zone is red from the proximal to the radial ligament.

When traumas are older, from 3 weeks to 6 months, the hematic synovitis probably concentrates itself in the disinsertion zone (Fig. 2) in radiocarpal and in midcarpal.

Fig. 2

Hematic synovitis at the foot of the radioscaphocapitate ligament: S1

A recent pathological wrist which has no hematic synovitis but a scapho- or triquetrolunate instability, or a laxity of the extrinsic ligamentous apparatus, has necessarily been previously injured. The trauma is often reported to be superior to 6 months.