Gandbhir Viraj N, Dussa Kumar, Kakadiya Ghanshyam, K K Nischay, Parekh Aseem
Department of Orthopaedics, T.N.M.C. and B.Y.L. Nair Ch. Hospital, Mumbai 400008, Maharashtra, India.
Trauma Case Rep. 2021 Jan 2;31:100395. doi: 10.1016/j.tcr.2020.100395. eCollection 2021 Feb.
Bone biopsies whether Computed Tomography guided or open, are one of the commonest procedures undertaken. Our literature review proves that bone biopsy needle fracture in a bone is a rare complication with no literature available on a needle fracture in a joint. We report a 7-year-old male who underwent an open needle biopsy. During the procedure, the bone biopsy needle fractured with the distal 2.7 cm fragment being completely embedded in the right sacroiliac joint. Considering the location of the fragment, the standard techniques described in literature for extraction could not be applied due to intra-articular nature of the fragment and the risk of complications. We describe a method using a 2.5 mm drill bit to safely extract the foreign body. We have found that reasonable erosion of adjacent cortex, exposes the needle tip, prevents the needle from shattering and avoids further articular damage. There was an uneventful 15 months follow up. This case highlights the fact that bone biopsy procedure mandates correct technique and supervision and as far as possible a disposable pre-sterilized bone biopsy needle should be used.
无论是计算机断层扫描引导下的还是开放式的骨活检，都是最常见的操作之一。我们的文献综述表明，骨内骨活检针断裂是一种罕见的并发症，而关于关节内针断裂尚无文献报道。我们报告一名7岁男性接受了开放式针活检。在操作过程中，骨活检针断裂，远端2.7厘米的碎片完全嵌入右骶髂关节。考虑到碎片的位置，由于碎片位于关节内的性质以及并发症风险，文献中描述的标准取出技术无法应用。我们描述了一种使用2.5毫米钻头安全取出异物的方法。我们发现，对相邻皮质进行合理的侵蚀，可以暴露针尖，防止针破碎，并避免进一步的关节损伤。随访15个月，情况良好。该病例突出了这样一个事实，即骨活检操作需要正确的技术和监督，并且应尽可能使用一次性预消毒骨活检针。
