An Alternative Tool for Muscle Biopsy Sample Mounting for Rural Primary Care Center

Dear Sir, Muscle biopsy is a vital diagnostic procedure and important for the diagnosis of neuromuscular disorders or myopathies. Muscle biopsy can be done by open or closed (needle or punch) methods with each having its own pros and cons. The procedure of muscle biopsy whether extracted from percutaneous or open method is standard and well described.[1] Open biopsy is preferred in adults and in cases where adequate tissue is desired, and it also ensures that the tissue is free from tendinous tissues. The aim is to procure a specimen in life-like state for further examination.[2] Various types of needle or instruments are described for specimen collection such as Bergström Needle or Weil-Blakesley conchotome in closed manner.[3] A slight stretched specimen ensuring normal resting length of the muscle is encouraged as better specimen for relevant studies. Pathologist opinion is ideal to ensure better selection of tissues and immediate postcollection processing as per the current best practices.[4] Prompt frozen or fixed specimen following the collection of tissue is considered valuable for good diagnosis [Figure 1].Figure 1: The stretched muscle biopsy specimen mounted in a frame made of K-wire and held by sutures in stretched positionMany text books describe the use of two hemostat clamps or artery forceps joined together with metal bar for holding muscle tissue in between their tips.[4] Use of sutures placed at either ends of muscle tissue specimen is another described technique to maintain their normal length. The availability of such a muscle clamp is a critical issue for sustainability of this method more so in the settings where muscle biopsies are not commonly performed. The clamp can be made from welding two hemostats together but that will make it a tedious and complicated process. We, hereby, describe a method with readily available and inexpensive implant – the K-Wire or Kirschner wire. It is most widely used implant in orhopedics operation theater and can be used as effective tool for mounting muscle biopsy specimen. A single K-wire can be fashioned to form a “W-”shaped frame, and the muscle tissue can be tied to either arm with thin sutures after obtaining suitable specimen. After the mounting, the whole specimen with frame can be sent in appropriate medium for diagnostic evaluation. We have used this method in few cases and found it to be handy requiring less resource and time.[5] Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.