Experience of the Hip Disarticulation for Hemophilic Pseudotumor

A 28-year-old man with hemophilia B, after falling down and striking his right thigh, was admitted to our hospital complaining chiefly of an inability to walk. On the physical examination, the mid-portion of his right thigh was spindle-shaped, tense, and swollen. The X-ray film revealed a pseudotumor and a fracture of the right femur. The patient didn't wish to have an operation and was therefore placed in skin traction for about 10 months under adequate replacement therapy for Factor IX using less than the standard minimam dose. Disarticulation of the right hip using Boyd's method was performed on February 17, 1978. The wound healed faster than expected under replacemtnt therapy of PTC during and after surgery PTC activity was frequently measured and no serious complications developed. The patient is now undergoing gait training, using a Canadian Hip. This case would indicate that any operation on hemophiliacs can be performed using adequate replacement therapy.

[1]  Å. Ahlberg On the natural history of hemophilic pseudotumor. , 1975, The Journal of bone and joint surgery. American volume.

[2]  M. Telfer,et al.  Surgery in hemophilic patients. , 1975, The Journal of bone and joint surgery. American volume.

[3]  J. J. Graham,et al.  Excision of pseudotumor with repair by bone graft of pathological fracture of femur in hemophilia. , 1973, The Journal of bone and joint surgery. American volume.

[4]  J. Ditunno,et al.  Lower extremity amputation in hemophilia. Case report and review of surgical principles. , 1972, The Journal of bone and joint surgery. American volume.

[5]  E. E. Brant,et al.  Radiologic aspects of hemophilic pseudotumors in bone. , 1972, The American journal of roentgenology, radium therapy, and nuclear medicine.

[6]  R. Duthie The Management of musculo-skeletal problems in the haemophilias , 1972 .

[7]  R. Duthie,et al.  Haemophilic cysts. Report of five cases. , 1969, The Journal of bone and joint surgery. British volume.

[8]  H. S. Kemp,et al.  The management of fractures in haemophilia and Christmas disease. , 1968, The Journal of bone and joint surgery. British volume.

[9]  J. M. Matthews,et al.  THE HAEMOPHILIC PSEUDOTUMOUR OR HAEMOPHILIC SUBPERIOSTEAL HAEMATOMA. , 1965, The Journal of bone and joint surgery. British volume.

[10]  J. Lewis,et al.  THE USE OF PLASMA FRACTION I TO MAINTAIN HEMOSTASIS FOLLOWING AMPUTATION FOR HEMORRHAGIC CYST OF THE THIGH IN A SEVERE HEMOPHILIAC. , 1965, Journal of Bone and Joint Surgery. American volume.