Skip to main content
Top
Published in: Archives of Orthopaedic and Trauma Surgery 5/2010

01-05-2010 | Orthopaedic Surgery

IIlizarov external fixator for bilateral severe flexion deformity of the knee in haemophilia: case report

Authors: Ashok Kumar, Vivek Logani, Devdatta Suhas Neogi, Shah Alam Khan, Chandra Shekhar Yadav, Seema Rao

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 5/2010

Login to get access

Abstract

Introduction

Deformity correction by Illizarov method in haemophilic patients is a rare phenomenon.

Aim

To correct the bilateral knee deformity by Illizarov in one sitting.

Materials and methods

Patient had fixed flexion deformity (100°) of both knees; posterior skin webs, posterior subluxation, wasting of quadriceps and <1% level of factor IX. Patient was managed with optimisation of factor IX level in perioperative period by factor IX supplementations. Deformities were corrected by Illizarov’s fixator on both lower limbs at 3 months and fixator was removed at 4 months. At 3 months, patient developed bilateral equinus deformity which was corrected by a dynamic foot sling and gentle tendoachillis stretching exercises.

Result

Patient had superficial pin tract infection at three sites. There were no episodes of bleeding from pin tracts or in knee joint during distraction period. Patient had bilateral knees flexion up to 120° with 5° extensor lag on the right side. Patient is going to college and walks with intermittent use of a hinge knee brace at 3 years follow-up.

Conclusion

Illizarov method is a safe, less invasive, effective, economical and truly biological method for correction of severe flexion deformities of knee in haemophilic patients.
Literature
1.
go back to reference Rodriguez-Merchan EC (1999) Therapeutic options in the management of articular contractures in haemophiliacs. Haemophilia 5(Suppl 1):5–9CrossRefPubMed Rodriguez-Merchan EC (1999) Therapeutic options in the management of articular contractures in haemophiliacs. Haemophilia 5(Suppl 1):5–9CrossRefPubMed
2.
go back to reference Wallny T, Eickhoff HH, Raderschadt G, Brackmann HH (1999) Hamstring release and posterior capsulotomy for fixed knee flexion contracture in haemophiliacs. Haemophilia 5(Suppl 1):25–27CrossRefPubMed Wallny T, Eickhoff HH, Raderschadt G, Brackmann HH (1999) Hamstring release and posterior capsulotomy for fixed knee flexion contracture in haemophiliacs. Haemophilia 5(Suppl 1):25–27CrossRefPubMed
3.
go back to reference Lee V, Srivastava A, PalaniKumar C, Daniel AJ, Mathews V, Babu N, Chandy M, Sundararaj GD (2004) External fixators in haemophilia. Haemophilia 10(1):52–57CrossRefPubMed Lee V, Srivastava A, PalaniKumar C, Daniel AJ, Mathews V, Babu N, Chandy M, Sundararaj GD (2004) External fixators in haemophilia. Haemophilia 10(1):52–57CrossRefPubMed
4.
go back to reference Kiely PD, McMahon C, Smith OP, Moore DP (2003) Treatment of flexion contracture of the knee using Illizarov technique in a child with haemophilia B. Haemophilia 9(3):336–339CrossRefPubMed Kiely PD, McMahon C, Smith OP, Moore DP (2003) Treatment of flexion contracture of the knee using Illizarov technique in a child with haemophilia B. Haemophilia 9(3):336–339CrossRefPubMed
5.
go back to reference Caviglia HA, Perez-Bianco R, Galatro G, Duhalde C, Tezanos-Pinto M (1999) Extensor supracondylar femoral osteotomy as treatment for flexed haemophilic knee. Haemophilia 5(Suppl 1):28–32CrossRefPubMed Caviglia HA, Perez-Bianco R, Galatro G, Duhalde C, Tezanos-Pinto M (1999) Extensor supracondylar femoral osteotomy as treatment for flexed haemophilic knee. Haemophilia 5(Suppl 1):28–32CrossRefPubMed
6.
go back to reference Luck JV Jr, Silva M, Rodriguez-Merchan EC, Ghalambor N, Zahiri CA, Finn RS (2004) Hemophilic arthropathy. J Am Acad Orthop Surg 12:234–245PubMed Luck JV Jr, Silva M, Rodriguez-Merchan EC, Ghalambor N, Zahiri CA, Finn RS (2004) Hemophilic arthropathy. J Am Acad Orthop Surg 12:234–245PubMed
Metadata
Title
IIlizarov external fixator for bilateral severe flexion deformity of the knee in haemophilia: case report
Authors
Ashok Kumar
Vivek Logani
Devdatta Suhas Neogi
Shah Alam Khan
Chandra Shekhar Yadav
Seema Rao
Publication date
01-05-2010
Publisher
Springer-Verlag
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 5/2010
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-009-0968-8

Other articles of this Issue 5/2010

Archives of Orthopaedic and Trauma Surgery 5/2010 Go to the issue