A 17-year-old with a suspected distal femoral osteosarcoma requires open biopsy. Which principle of biopsy technique is essential to preserve the option of subsequent limb salvage surgery?

• A Transverse incision over the most prominent part of the swelling for best cosmesis
• B Longitudinal incision placed along the line of the planned future resection, with the biopsy track excised en bloc at definitive surgery ✓
• C Multiple samples taken through separate punctures to improve diagnostic yield
• D Drain placed laterally away from the incision to prevent haematoma formation

Explanation

The biopsy track is contaminated by tumour seeding and must be resected en bloc with the specimen at definitive surgery. Therefore the incision should be longitudinal, aligned with the planned resection incision, and placed so that it lies within the future surgical field. Transverse incisions force a wider resection, multiple tracks contaminate several compartments, and drains must exit close to and in line with the biopsy wound, not remotely.

Reference: Campbell's Operative Orthopaedics, 14th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.