bone fracture, nonunion, electrical stimulation for
A method of stimulating a nonunion bone fracture to heal through an invasive or noninvasive electromagnetic field. Invasive electrical stimulation involves the implantation of electrodes into the bone proximal and distal to the fracture site. Surface electrodes are placed on the skin over the area of fracture for the noninvasive technique. SEE: nonunion.
bone marrow aspiration and biopsy
The removal of a small amount of tissue (bone marrow biopsy) and fluid filled with blood cells (bone marrow aspiration) from the central core of a bone. The aspiration and biopsy are used to diagnose blood disorders such as anemias and cancers, infectious diseases that affect the marrow, or to gather cells for later infusion into a patient, e.g., in bone marrow transplantation.
PATIENT CARE: The purpose of the test is explained to the patient (and family as necessary). The patient is advised that some discomfort or pressure may be felt, e.g., a crunching or popping sound may be heard as the needle penetrates the bone. A signed, informed consent must be obtained before the procedure. The patient's history is reviewed, including risk for bleeding, coagulation studies, platelet count, anticoagulant therapy, and use of drugs or supplements that interfere with clotting. The patient is also assessed for allergies to antiseptic or anesthetic solutions. The patient is advised that he or she must remain still throughout the procedure, and the ability to do so is assessed. Baseline signs are recorded, and a sedative is administered as prescribed. The patient is assisted to the appropriate position for the insertion site: the lateral decubitus position for the posterior iliac crest and the supine position for the sternum or anterior iliac crest. The health care provider helps the patient maintain the desired position. The patient is encouraged to take deep breaths and use relaxation techniques during the procedure.
A sterile prepackaged set is used for the aspiration, and the practitioner is assisted as necessary. The patient is assessed throughout the procedure for pallor, diaphoresis, or other changes. After the aspiration, direct pressure is applied to the puncture site for 5 to 10 minutes or according to agency policy until bleeding is controlled; the wound is then covered with a sterile dressing. The patient is helped into a comfortable position, and vital signs are checked. The puncture site is reassessed as necessary for bleeding. All specimens are labeled and transported to the laboratory. Postprocedure pain intensity is evaluated, and analgesia is provided as prescribed. The patient is advised to watch for and report any signs of infection and is warned to avoid any drugs containing acetylsalicylic acid (aspirin), which may cause bleeding.
Specimens of marrow and aspirate are sent to the cytology or pathology laboratory for microscopic analysis, to the microbiology laboratory if cultures ...