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    Desenvolvimento de índices radiográficos para auxílio ao diagnóstico das lesões perilunares
    (Universidade Federal de São Paulo (UNIFESP), 2020-03-26) Pinto, Fernando Nogueira Zambone [UNIFESP]; Fernandes, Carlos Henrique [UNIFESP]; Universidade Federal de São Paulo
    Objective: The objective of this study was to develop radiographic indexes that help the diagnostic confirmation of perilunate injuries. Methods: A descriptive, crosssectional, retrospective study was carried out with the objective of finding radiographic indexes that facilitate the diagnosis of perilunate injuries. Eighty wrist radiographs were evaluated, divided into 20 radiographs without changes and 20 radiographs with the following diagnosis: scapholunate ligament injury, transcaphoid fracture dislocation, lunate dislocation. All diagnoses were confirmed by the finding of an anatomical injury during the surgical procedure that treated the respective injuries. In the PA incidence radiographs of the wrist, we determined bone points that originated lines to evaluate the anatomical relationship between the carpal bones. The ulnar translation index (UTI) and the modified carpal height index (MCHI) were measured. On lateral wrist radiographs, bone points were selected that originated lines to evaluate the anatomical relationship between the carpal bones. The radiolunate index (RLI) was calculated. The Kruskal-Wallis test and graphical analysis using box plot were used in the statistical analysis. The result of each comparison presents a p value, being defined as a significance value of 0.05 (5%). Results: The UTI, on the radiographs of the wrists considered without changes, ranged from 0.534 ± 0.058, on the radiographs diagnosed with lesion of the scapholunate ligament, ranged from 0.560 ± 0.075, on the radiographs with diagnosis of transescapho-lunate fracture dislocation, it was found a range from 0.557 ± 0.138 and on the radiographs with a diagnosis of lunate dislocation it ranged from 0.628 ± 0.059. The p-value found for the UTI study was 0.062. The MCHI on the radiographs of the wrists without changes ranged from 2.538 ± 0.152, on the radiographs diagnosed with scapholunate ligament injury ranged from 2.534 ± 0.146, on the radiographs with diagnosis of transescapho-lunate fracture dislocation, ranged from 2.524 ± 0.155, on radiographs with a diagnosis of lunate dislocation ranged from 2.52 ± 0.13. The p-value for MCHI was 0.973. The RLI on the radiographs of the wrists without changes ranged from 1,136 ± 0.172. In the radiographs with diagnosis of scapholunate ligament injury, the index ranged from 1.907 ± 0.428, in the radiographs with diagnosis of transescapho-lunate fracture dislocation, it varied from 0.743 ± 0.099 and in the radiographs with diagnosis of lunate dislocation it ranged from xiv 0.47 ± 0.086 . The p-value for RLI was less than 0.001. Conclusion: The application of the UTI demonstrated that there is a statistical tendency for ulnar translation in the perilunate injuries. Its clinical applicability to aid in the diagnosis of perilunate injury rely on complementary studies. The MCHI has demonstrated that there is no change in carpal height in perilunate injuries. It cannot be clinically applied to aid in the diagnosis of perilunate injuries. The application of the RLI demonstrated that there is a change in the position of the lunate in relation to the articular surface of the radius in perilunate injuries. Thus, it can be applied clinically to aid in the diagnosis of perilunate injuries.