A 16-year-old boy has a suspicious destructive lesion of the proximal tibia. Core needle biopsy is planned. Which principle of biopsy technique is most important to preserve the option of subsequent limb salvage surgery?
- A The shortest transverse route to the lesion should be used to minimise tissue damage
- B The biopsy tract should be placed along the longitudinal axis of the limb, in line with the incision planned for definitive resection ✓
- C The biopsy should be taken through the most oedematous part of the swelling away from the tumour core
- D A drain should be left in the biopsy tract to prevent haematoma formation
Correct answer: B. The biopsy tract should be placed along the longitudinal axis of the limb, in line with the incision planned for definitive resection
Explanation
The biopsy tract becomes contaminated with tumour cells and must be excised en bloc with the specimen at definitive surgery. B tract placed longitudinally, in line with the future resection incision and within the same compartment that will be removed, allows this. B transverse or random tract crosses uninvolved compartments and may convert a salvageable case into one requiring amputation. Drains are placed in line with the tract if used at all.
Reference: Campbell's Operative Orthopaedics, 14th ed.
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