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外固定治疗双侧忽视性血友病马蹄足挛缩的手术治疗:一例报告

Surgical Treatment of Neglected Bilateral Hemophilic Equinus Contracture With External Fixation: A Case Report.

作者信息

Yontar Necip Selcuk, Can Ata, Ögüt Tahir

机构信息

Orthopedist, Nisantasi Ortopedi Merkezi, Unimed Center, Fulya, Turkey.

Orthopedist, Nisantasi Ortopedi Merkezi, Unimed Center, Fulya, Turkey.

出版信息

J Foot Ankle Surg. 2018 May-Jun;57(3):605-609. doi: 10.1053/j.jfas.2017.10.022. Epub 2018 Feb 19.

Abstract

Hemophilia is a disorder of blood coagulation with X-linked recessive inheritance. It is characterized by uncontrollable hemorrhage, and 80% of these occur intraarticularly. With recurrent hemarthrosis, recurrent synovitis occurs, which eventually leads to the formation of articular contractures. The key to the prevention of hemophilic joint complications is successful prevention of bleeding and management of the initial hemarthrosis. However, after the development of a rigid contracture, surgical correction remains the only method to correct the deformity. Achilles tendon lengthening, synovectomy, anterior osteophyte resection, corrective osteotomies, external fixators, or arthrodesis should be considered as surgical options. In the present report, we describe our experience using hybrid-type external fixators to manage bilateral neglected rigid equinus contractures in a hemophilic patient, with 78 months of follow-up data.

摘要

血友病是一种具有X连锁隐性遗传的血液凝固障碍性疾病。其特征为无法控制的出血,其中80%发生在关节内。随着反复的关节积血,反复的滑膜炎会发生,最终导致关节挛缩的形成。预防血友病关节并发症的关键在于成功预防出血以及对初始关节积血的处理。然而,在出现僵硬挛缩后,手术矫正仍是纠正畸形的唯一方法。跟腱延长术、滑膜切除术、前方骨赘切除术、矫正截骨术、外固定器或关节融合术都应被视为手术选择。在本报告中,我们描述了我们使用混合型外固定器治疗一名血友病患者双侧被忽视的僵硬马蹄足挛缩的经验,并提供了78个月的随访数据。

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