Heim M, Steinbach T
Department of Orthopaedic Rehabilitation, Chaim Sheba Medical Center, Tel-Hashomer Hospital, Israel.
Orthop Rev. 1988 Oct;17(10):975-8.
The availability of concentrated coagulation factor has dramatically changed the effects of hemophilia on the musculoskeletal system. Limb angular deformities, on the whole, can be prevented by intensive medical and surgical care, but hemarthroses result in constantly changing joint circumferences and ranges of movement. Orthoses provide little protection against hemarthrosis and the unstable configurations contraindicate the use of rigid orthotic devices. Modern treatment protocols call for early and adequate factor replacement and physiotherapy. As an adjuvant to this form of therapy, anatomically constructed elastic joint supports and/or transcutaneous electric nerve stimulation (TENS) have been used.
浓缩凝血因子的可获得性极大地改变了血友病对肌肉骨骼系统的影响。总体而言，肢体角畸形可通过强化医疗和手术护理来预防，但关节积血会导致关节周长和活动范围不断变化。矫形器对关节积血几乎没有保护作用，且不稳定的结构不适合使用刚性矫形装置。现代治疗方案要求早期且充分地补充凝血因子并进行物理治疗。作为这种治疗形式的辅助手段，已使用了符合解剖结构的弹性关节支撑物和/或经皮电刺激神经疗法（TENS）。
