Prevalencia de lesiones traumáticas ocultas en muñeca y tobillo: revisión sistemática y metaanálisis

Introduction: The wrist and ankle are complex anatomical regions and prone to injuries that may be missed, when evaluated with conventional radiography. Late treatment of an occult injury impacts on the quality of life of the patient and on the resources of the health system. Aim: To determine the prevalence of occult traumatic injuries on conventional radiography of the wrist and ankle in the general population. Material and methods: A systematic search was performed in Medline, CINAHL, Scopus, Cochrane library, Embase, Google Scholar, OpenGray, and Proquest databases. A meta-analysis of proportions was performed to estimate the prevalence of occult bone lesions. Results: In the wrist, the global prevalence of occult traumatic injuries was 36% (95% CI: 24.0-49.0) and in adults 31% (95% CI: 20.0-43.0). In the ankle, the global prevalence of occult traumatic injuries was 34% (95% CI: 19.0-51.0) and in adults 47% (95% CI: 38.0-56.0). Conclusions: The results of the meta-analysis show a global pooled prevalence of occult traumatic injuries for the wrist of 36% and for the ankle of 34%, for which it is important to consider a systematic approach to the interpretation of radiographic images of the wrist and ankle in order to mitigate diagnostic errors.