Name of the Procedure:

Biopsy, bone, open; deep (e.g., humeral shaft, ischium, femoral shaft)

Summary

A deep bone biopsy is a surgical procedure where a small sample of bone tissue is removed from deep areas such as the humeral shaft, ischium, or femoral shaft for examination. This helps in diagnosing various bone diseases, infections, or cancers.

Purpose

This procedure is primarily performed to diagnose bone conditions that are not apparent from non-invasive tests. The goals are to identify infections, tumors, or other bone diseases accurately to guide appropriate treatment.

Indications

• Persistent bone pain or swelling
• Unexplained fractures
• Detection of bone cancer or metastasis
• Evaluation of chronic bone infections (osteomyelitis)
• Unclear bone abnormalities seen in imaging tests

Preparation

• Patients may be asked to fast for several hours before the procedure.
• Certain medications may need to be adjusted or stopped as advised by the doctor.
• Relevant imaging tests like MRIs, CT scans, or X-rays might be performed prior.
• Preoperative assessments, including blood tests and medical history evaluation.

Procedure Description

1. The patient receives general anesthesia to ensure they are asleep and pain-free.
2. The surgical area is cleaned and sterilized.
3. An incision is made over the targeted bone area.
4. Special tools are used to access and extract a small sample of bone tissue.
5. The sample is collected and sent to a laboratory for analysis.
6. The incision is closed with sutures or staples.
7. A sterile dressing is applied to the wound.

Duration

The procedure typically takes about 1-2 hours.

Setting

The procedure is performed in a hospital or a surgical center.

Personnel

• Orthopedic surgeon or surgical oncologist
• Nurses and surgical assistants
• Anesthesiologist

Risks and Complications

• Infection at the biopsy site
• Bleeding or hematoma
• Damage to surrounding tissues or nerves
• Pain or discomfort at the biopsy site
• Uncommon risks include fracture of the bone during the procedure

Benefits

• Accurate diagnosis of bone conditions
• Helps in formulating appropriate treatment plans
• Can provide relief through timely and targeted treatment

Recovery

• Patients may experience soreness and swelling at the biopsy site.
• Pain management may include prescribed pain relievers.
• Activity restrictions to avoid stressing the biopsy site.
• Follow-up appointments to monitor healing and discuss biopsy results.
• Recovery time can vary but typically ranges from several days to a few weeks.

Alternatives

• Needle biopsy (less invasive but may not be as comprehensive)
• Imaging tests alone (may not provide definitive diagnosis)
• Watchful waiting (appropriate in some cases but delays intervention)

Patient Experience

• During the procedure, the patient is under anesthesia and doesn’t feel pain.
• Post-procedure, some discomfort and soreness are expected, managed with pain medications.
• Rest and limited physical activity are advised for proper healing and comfort.

By following the above guidelines and understanding the procedure, patients can be better prepared and aware of what to expect from an open deep bone biopsy.