[Histonet] Re: Bone saw

[Robert Richmond]

Christine Bark asks about saws for cutting surgical pathology bone
specimens like femoral heads.

I posted something to Histonet about this fairly recently - here it is again.
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Stephen Peters, a pathologist in Hackensack NJ, describes for us a
bone saw he's invented. His Web site is distinctly worth looking at,
the whole thing, not just the saw.
http://pathologyinnovations.com/bone_vise.htm

Some other possibilities for sawing bone:

Many of the small pathology services I work for have no way of sawing
bone. (It's amazing how many pathologists there are who are so poorly
trained that they think you decalcify a femoral head by tossing the
whole thing in formalin for a month.) In that circumstance, I head for
the nearest hardware store and buy a five dollar hacksaw which I leave
behind at the end of the week.

The Civil War vintage Satterlee amputation saw is still available, and
is a serviceable hand saw that doesn't go dull quickly. (I've seen
them, complete with chrome plating, at Civil War re-enactments.) This
is the tool I most commonly use.

One of the standard vendors offers a simple device for slabbing a
femoral head, the SawBones, absurdly overpriced at $500, not something
a hospital would be likely to buy for a mere pathologist.

Several years ago I attended a continuing medical education program
where the lecturer recommended a scroll saw, a large table saw that's
about impossible to injure yourself with. At the time they cost about
$100 for Made in China, otherwise $200. The disadvantage, in a cramped
pathology lab, is its large footprint. You can look at these things at
your local Home Depot.

There's no way to cut a femoral head safely with an oscillating
autopsy saw (Stryker saw), though this is probably the most common way
to cut bone.

I think femoral heads removed for fracture (not for osteoarthritis)
really do need to be examined microscopically, because of the
occasional pathologic fracture (fracture through metastatic cancer in
the bone). I've seen several of these, not all with a previous cancer
diagnosis. (But I see no reason to examine knee replacement material
microscopically, if you know how to do the gross description properly
- which admittedly most pathologists don't.)

(I have no connection with any of the businesses I've mentioned.)

Bob Richmond
Samurai Pathologist
Knoxville TN