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Lessons Learned: Deformity Correction and Tibiotalocalcaneal Arthrodesis in a Patient With Glanzmann Thrombasthenia:
Kenrick Lam1, Cory Janney1,2, Vinod Panchbhavi1
1Department of Orthopaedic Surgery and Rehabilitation, University of Texas Medical Branch, Galveston, Texas.
Case:
A 33-year-old woman with Glanzmann thrombasthenia presented to us with a distal tibia nonunion. We attempted to treat her with a multiplanar ring external fixator, but the patient was unable to tolerate the correction, so we resorted to a tibiotalocalcaneal fusion. Hemostasis was difficult to achieve despite the use of antithrombinolytics, factor VII, and platelet transfusions.
Conclusion:
Bleeding can be difficult to control in patients with Glanzmann thrombasthenia. However, overaggressive preadministration of antithrombinolytics should be avoided because it may have adverse effects such as acrocyanosis. The presence of thrombasthenia does not seem to affect the success of arthrodesis.
