Lee V N, Srivastava A, Nithyananth M, Kumar P, Cherian V M, Viswabandya A, Mathews V, George B, Venkatesh K, Nair S C, Chandy M, Sundararaj G D
Department of Orthopaedics, Unit One, Christian Medical College, Vellore, India.
Haemophilia. 2007 Jul;13(4):391-4. doi: 10.1111/j.1365-2516.2007.01448.x.
We describe here the management of eleven patients with fracture neck of femur. Excepting one patient all had severe haemophilia A. Nine patients were less than 50 years of age. Eight out of eleven patients had fracture after trivial trauma. Nine patients had closed reduction and one patient open reduction. The patient with non union had a Valgus osteotomy. All fractures united. The average time to union was 11 weeks (range:8-16). We followed either a low dose intermittent or a low dose continuous infusion factor support protocol for the management of these patients. The median dose of factor support was 252 u/kg (range: 136-580). The average duration of factor support was 9 days (range: 7-10). Two patients had aggravation of pre existing knee stiffness following post operative immobilisation. No other major complication was observed in this cohort of patients. To conclude, management of fracture neck of femur in patients with haemophilia is no different from general population if an adequate haemostasis is achieved.
我们在此描述11例股骨颈骨折患者的治疗情况。除1例患者外，其余均患有重度甲型血友病。9例患者年龄小于50岁。11例患者中有8例在轻微创伤后发生骨折。9例行闭合复位，1例行切开复位。骨折不愈合的患者接受了外翻截骨术。所有骨折均愈合。平均愈合时间为11周（范围：8 - 16周）。我们采用低剂量间歇或低剂量持续输注因子支持方案来治疗这些患者。因子支持的中位剂量为252 u/kg（范围：136 - 580）。因子支持的平均持续时间为9天（范围：7 - 10天）。2例患者术后固定后原有膝关节僵硬加重。该组患者未观察到其他重大并发症。总之，如果能实现充分止血，血友病患者股骨颈骨折的治疗与普通人群无异。
