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External fixators in haemophilia.

V Lee1, A Srivastava, C PalaniKumar

  • 1Department of Orthopaedic Surgery Unit 1, Christian Medical College Hospital, Vellore, India. vlee@cmcvellore.ac.in

Haemophilia : the Official Journal of the World Federation of Hemophilia
|February 14, 2004
PubMed
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External fixators (EF) offer a safe treatment option for hemophilia patients without inhibitors. This method requires minimal factor replacement, facilitating bone healing and joint stabilization.

Area of Science:

  • Orthopedic Surgery
  • Hematology

Background:

  • External fixators (EF) are infrequently utilized in hemophilia patients.
  • Hemophilia management often involves cautious surgical approaches due to bleeding risks.

Purpose of the Study:

  • To evaluate the safety and efficacy of external fixator application in hemophilic patients.
  • To assess factor replacement requirements during EF treatment for orthopedic conditions.

Main Methods:

  • Retrospective analysis of nine hemophilic patients treated with various external fixator types (Ilizarov, AO, Charnley).
  • Indications included infected joint arthrodesis, open fractures, and osteoclasis.
  • Factor replacement was managed perioperatively and during healing, with reduced levels maintained postoperatively.

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Main Results:

  • External fixators were used for an average of 15 weeks with minimal factor replacement.
  • Preoperative factor levels averaged 85%, with lower levels maintained during wound healing.
  • No major complications occurred, except in one patient who developed inhibitors.

Conclusions:

  • External fixators can be safely employed in hemophilic patients, particularly those without inhibitors.
  • The treatment necessitates limited and strategically timed factor replacement, supporting bone healing.