Accuration of Fine Needle Aspiration Biopsy in Musculoskeletal Tumour

Fine needle aspiration biopsy (FNAB) has been reported to be the preferable choice of biopsy for musculoskeletal tumour. While FNAB appears to have advantages to core biopsy in the aspect of simplicity and cost, the diagnostic accuracy should be the most critical parameter in determining the choice of biopsy. This research was designed to evaluate the diagnostic accuracy of fine needle aspiration in musculoskeletal tumour in Sardjito Hospital from 2010 until 2014. This was a descriptive study from medical record in Sardjito Hospital from 2010 until 2014. The inclusion criteria are musculoskeletal tumours in all age level that has been performed FNAB with subsequent operative treatment and confirmation of histopathology examination in Sardjito Hospital. There were 41 elligible subjects in this study. Concordance diagnosis of FNAB and histopathological examination in all musculoskeletal tumor cases was found to be 86%. In addition, the concordance in soft tissue tumor cases was 94% with the detail as follows: giant cell tumor was 86%, synovial sarcoma was 50% and liposarcoma was 50%. In bone tumours, the accuracy was found to be 60% with the detail as follows: distribute osteosarcoma was 60%, osteochondroma was 50% and chondrosarcoma was 50%. Our data showed that accuracy of FNAB for diagnosis of musculoskeletal tumours was 86% with soft tissue tumour 94%, bone tumour 60% and others 93%. Therefore, Fine needle aspiration biopsy is still important diagnosis tool in musculoskeletal tumours

Treating natural disaster victims is dealing with shortages:An orthopaedics perspective

During natural disasters such as earthquakes or tsunamis, most of the casualties are known to suffer from musculoskeletal injuries. This leads to an enormous need of orthopaedic (surgical) implants such as osteosynthesis plates, which are difficult to provide in developing countries that rely on imported ones. One of the alternatives is utilization of local resources, but only after they have been proven safe to use, and meet the international standards set. Through this paper we would like to urge the international community to include locally produced biomedical products, like osteosynthesis plates in their scientific evaluations and communications. When the quality of local products is proven, the reluctance to use local products also by surgeons from developing countries will disappear and larger scale production can be initiated. This in its turn solves many problems that come after natural disasters and stimulates the national economy in an efficient and effective way

Biomechanical and surface physico-chemical analyses of used osteosynthesis plates and screws - Potential for reuse in developing countries?

Reprocessing of single-use devices is an upcoming issue in the Western world, but has been for many years in developing countries. In developing countries, the number of bone fractures due to traffic or industrial accidents is high. Patients often need an osteosynthesis with plates and screws, but most patients, however, cannot afford this because of the costs involved and have to rely on the application of used plates and screws. This study aims to determine whether used plates can be safely reused in another patient from a biomechanical, surface physico-chemical, and biological point-of-view. Osteosynthesis plates weakened in a predictable way during use, regardless of the history, presumably because tests were conducted under extreme conditions in the absence of clinically applied load-sharing between bone and plate. Surface physico-chemical analyses indicated that used plates and screws were more hydrophillic than new ones; had increased amounts of calcium-phosphates at their surfaces and possessed higher number of scratches. Pitting corrosion could be seen on SEM micrographs. Simple cleaning methods, as available in developing countries, including toothbrush, water, detergent and bleach yielded elemental surface compositions, and hydrophobicities similar to those of new ones, while biologically thus cleaned screws were not cytotoxic according to ISO-10993-5 and endotoxin release according to USP-27-NF-22 was within the requirements of the FDA. It is concluded that the reuse of osteosynthesis plates and screws are not necessarily unsafe, although preferably a register should be kept of all previous users to limit the number of reuses as mechanical weakening does occur. (c) 2006 Wiley Periodicals, Inc