title: Intramedullary reamings for the histological diagnosis of suspected pathological fractures.
abstract: The aim of this study was to evaluate how effective reamings taken at the time of surgery for fracture were in the diagnosis of malignancy. All histology reports over a five-year period were examined. Ninety cases, where reamings were taken, were identified and included. Reamings are commonly sent for histological diagnosis in orthopaedic practice. A definitive tissue diagnosis was established in 55 samples (60%). No diagnosis was established in 30 (33%), as the tissue sample was deemed inadequate, 17 of which were known to have a malignancy elsewhere. Five case reports were lost. The process by which the bone samples were obtained is believed to be very destructive, making histological diagnosis difficult and unreliable. Our study does not support the use of reamings for histology. An alternative technique should be used such as biopsy with the Harlow-Wood trephine.
authors.affiliation: Queen's Medical Centre Nottingham, University Hospital NHS Trust, Derby Road, Nottingham NG7 2UH, UK. kamranhassan_4@hotmail.com
authors.forename: K
authors.initials: K
authors.lastname: Hassan
authors.forename: S
authors.initials: S
authors.lastname: Kalra
authors.forename: C
authors.initials: C
authors.lastname: Moran
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D001859:Bone Neoplasms / Q000150:complications / Q000473:pathology / Q000556:secondary*; D003937:Diagnosis, Differential; D005260:Female; D005264:Femoral Fractures / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D005269:Femur / Q000473:pathology*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation; D005598:Fractures, Spontaneous / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D009362:Neoplasm Metastasis; D015203:Reproducibility of Results; D012189:Retrospective Studies