External fixators in haemophilia

Haemophilia. 2004 Jan;10(1):52-7. doi: 10.1046/j.1365-2516.2003.00844.x.

Abstract

External fixators (EF) are not commonly used for patients with haemophilia. We describe the use of EF (Ilizarov, AO- uni- and bi-planar fixators and Charnley clamp) in nine patients (mean age: 19.2 years; range: 9-37) with haemophilia for the following indications - arthrodesis of infected joints, treatment of open fractures and osteoclasis. EF required an average of nine skin punctures [range: 4-17 were maintained for a period of 15 weeks (range: 8-29.5), without regular factor replacement, till bone healing was adequate and were removed with a single dose of factor infusion]. The mean preoperative factor level achieved was 85% (range: 64-102%). Much lower levels were subsequently maintained till wound healing. The average total factor consumption was 430 IU kg(-1) (range: 240-870), administered over a period of 17 days (range: 9-44). There were no major complications related to EF except in a patient who developed inhibitors. In conclusion, EF can be used safely in haemophilic patients who do not have inhibitors and does not require prolonged factor replacement.

MeSH terms

  • Adolescent
  • Adult
  • Arthritis / surgery*
  • Arthrodesis / methods
  • Child
  • External Fixators*
  • Fractures, Bone / surgery*
  • Hemophilia A / complications*
  • Hemophilia B / complications*
  • Humans
  • Punctures
  • Surgical Wound Infection / drug therapy
  • Surgical Wound Infection / etiology