Maceration Of Bone

Maceration of bone yields instructive specimens that are esthetically satisfying and of unlimited durability.

The specimens shown in Figs. 8-1, 8-2, and 8-3 (Courtesy, the late Prof. Dr. E. Uehlinger) were prepared in the Department of Pathology, Zürich, Switzerland, by the antiformin maceration technique.

METHOD OF ANTIFORMIN MACERATION (Pathology Laboratory Zürich; Bürgi, personal communication).

1. Clean attached soft tissue mechanically from bone (avoid knife marks).

2. Immerse specimen in a glass jar with 3% antiformin solution. (Antiformin stock solution: 1,400 mL sodium

Pictures Maceration Bones
Fig. 8-2. Macerated humerus. Severe destruction of cancellous bone by multiple myeloma: 61-yr-old man.

hypochlorite, 10% solution; 1,400 mL distilled water; 4,200 mL potassium hydroxide, 45% (w/w). For maceration of bones, 1, 2, and 3% dilutions of this stock solution are prepared.) Place the jar in an incubator (embedding oven) at 70-80°C for 3-4 h. The time of incubation may be less with small or more with large specimens.

3. Decant antiformin and flush specimen with hot water. The remaining fragments of soft tissue are removed by blowing compressed air through the specimen and by scratching them from the surface of the bone with a knife. Occasionally, the specimen has to be incubated again in 1 or 2% antiformin. Check the progress every 30 min. Repeat step 3.

4. Bleach bone with 3% hydrogen peroxide solution in an incubator at 70-80°C. Bleaching time is 12-24 h. Flush in hot water.

5. Place specimen in cotton and dry at room temperature.

6. Place specimen in ether for about a week. This is to remove fat that has remained in the bone. The duration of ether treatment depends on the amount of fat in the tissue. Subsequently, the tissue is air-dried. Specimens can also be degreased with carbon tetrachloride or tetra-chloroethylene. These are excellent fat solvents (Caution: proper ventilation is needed).

OTHER METHODS Maceration also can be achieved by prolonged putrefaction, by treatment with 0.25 N NaOH at 90°C, or by autoclaving with 1 NNaOH (11). Repeated checking and mechanical removal of soft tissue are essential in all methods.

A slow but safe method is to boil the specimen until only the bone is left. If the bone is very fatty, incubation for 2 d in 50% ether-acetone will remove the fat and facilitate removal of the organic material. Some mineral is lost by this procedure. This

Fig. 8-3. Macerated tibia (horizontal section). Periosteal new bone formation in hypertrophic osteoarthropathy associated with carcinoma of breast and multiple metastases: 58-yr-old woman.

method is particularly recommended if one is dealing with a very valuable specimen.

Enzymatic maceration (12) is carried out with 0.1% papain in isotonic saline. The specimen is incubated for 24 h at 37°C. washed, and bleached in hydrogen peroxide.

FOR STUDY OF EXHUMED BONES Boiling is the method of choice. Maceration may permit otherwise unobtainable diagnoses, not only in medicolegal autopsies on bodies that had been buried for months and years but also for historic and prehistoric material.

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