title: Fracture neck of femur in haemophilia A - experience from a cohort of 11 patients from a tertiary centre in India.
abstract: 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.
authors.affiliation: Department of Orthopaedics, Unit One, Christian Medical College, Vellore, India. vlee@cmcvellore.ac.in
authors.forename: V N
authors.initials: VN
authors.lastname: Lee
authors.forename: A
authors.initials: A
authors.lastname: Srivastava
authors.forename: M
authors.initials: M
authors.lastname: Nithyananth
authors.forename: P
authors.initials: P
authors.lastname: Kumar
authors.forename: V M
authors.initials: VM
authors.lastname: Cherian
authors.forename: A
authors.initials: A
authors.lastname: Viswabandya
authors.forename: V
authors.initials: V
authors.lastname: Mathews
authors.forename: B
authors.initials: B
authors.lastname: George
authors.forename: K
authors.initials: K
authors.lastname: Venkatesh
authors.forename: S C
authors.initials: SC
authors.lastname: Nair
authors.forename: M
authors.initials: M
authors.lastname: Chandy
authors.forename: G D
authors.initials: GD
authors.lastname: Sundararaj
mesh_terms: D000293:Adolescent; D000328:Adult; D005169:Factor VIII / Q000627:therapeutic use*; D005265:Femoral Neck Fractures / Q000209:etiology / Q000601:surgery*; D005592:Fracture Fixation / Q000379:methods*; D006467:Hemophilia A / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007194:India; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D005169:Factor VIII