Retrieval of broken bone biopsy needle from the sacroiliac joint - A case report and review of literature

Trauma Case Rep. 2021 Jan 2:31:100395. doi: 10.1016/j.tcr.2020.100395. eCollection 2021 Feb.

Abstract

Bone biopsies whether Computed Tomography guided or open, are one of the commonest procedures undertaken. Our literature review proves that bone biopsy needle fracture in a bone is a rare complication with no literature available on a needle fracture in a joint. We report a 7-year-old male who underwent an open needle biopsy. During the procedure, the bone biopsy needle fractured with the distal 2.7 cm fragment being completely embedded in the right sacroiliac joint. Considering the location of the fragment, the standard techniques described in literature for extraction could not be applied due to intra-articular nature of the fragment and the risk of complications. We describe a method using a 2.5 mm drill bit to safely extract the foreign body. We have found that reasonable erosion of adjacent cortex, exposes the needle tip, prevents the needle from shattering and avoids further articular damage. There was an uneventful 15 months follow up. This case highlights the fact that bone biopsy procedure mandates correct technique and supervision and as far as possible a disposable pre-sterilized bone biopsy needle should be used.

Keywords: Bone biopsy; Broken needle; Drill bit; Needle fracture; Needle in a joint; Needle removal.

Publication types

  • Case Reports