Treatment of fracture in haemophilia: a retrospective study

Fractures in persons with haemophilia (PWH) exhibit similarities and distinctions compared to typical fractures. However, complications confer an added increase in the risk of fractures. This study aimed to summarize the treatment experience of fractures in PWH based on a classification.

A retrospective cohort study was conducted on PWH between 2001 and 2023. The classification was developed into three types according to PWH's clinical presentations and imaging findings. Subsequently, the distribution and distinctions among subtypes were analyzed, followed by an exploration of risk factors for fracture-related complications.

A total of 61 fractures in PWH met the inclusion and exclusion criteria. The median follow-up duration was 6.87 years. Type II and III fractures in PWH exhibited a longer time of fracture healing and hospital stay, along with increased fracture-related complication rates. In further analysis, the operative time and intraoperative blood loss also increased significantly. Furthermore, compared to non-surgical approaches, the surgical treatment appeared to reduce the incidence of fracture-related complications. Next, the femur was identified as the most frequently fractured site. Plate fixation was the predominant surgical approach for types II (20/29) and III (8/13).

This study reviews treatment experience for fractures in PWH according to a classification and stresses the importance of surgery. The classification may provide a potential strategy for post-operative care. However, further classification is required.