title: IIlizarov external fixator for bilateral severe flexion deformity of the knee in haemophilia: case report.
abstract: BACKGROUND
  Deformity correction by Illizarov method in haemophilic patients is a rare phenomenon.
  
  
  OBJECTIVE
  To correct the bilateral knee deformity by Illizarov in one sitting.
  
  
  METHODS
  Patient had fixed flexion deformity (100 degrees ) of both knees; posterior skin webs, posterior subluxation, wasting of quadriceps and <1% level of factor IX. Patient was managed with optimisation of factor IX level in perioperative period by factor IX supplementations. Deformities were corrected by Illizarov's fixator on both lower limbs at 3 months and fixator was removed at 4 months. At 3 months, patient developed bilateral equinus deformity which was corrected by a dynamic foot sling and gentle tendoachillis stretching exercises.
  
  
  RESULTS
  Patient had superficial pin tract infection at three sites. There were no episodes of bleeding from pin tracts or in knee joint during distraction period. Patient had bilateral knees flexion up to 120 degrees with 5 degrees extensor lag on the right side. Patient is going to college and walks with intermittent use of a hinge knee brace at 3 years follow-up.
  
  
  CONCLUSIONS
  Illizarov method is a safe, less invasive, effective, economical and truly biological method for correction of severe flexion deformities of knee in haemophilic patients.
authors.affiliation: Department of Orthopaedics and Haematology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110 029, India.
authors.forename: Ashok
authors.initials: A
authors.lastname: Kumar
authors.forename: Vivek
authors.initials: V
authors.lastname: Logani
authors.forename: Devdatta Suhas
authors.initials: DS
authors.lastname: Neogi
authors.forename: Shah Alam
authors.initials: SA
authors.lastname: Khan
authors.forename: Chandra Shekhar
authors.initials: CS
authors.lastname: Yadav
authors.forename: Seema
authors.initials: S
authors.lastname: Rao
mesh_terms: D000293:Adolescent; D001915:Braces; D016267:External Fixators; D005164:Factor IX / Q000008:administration & dosage; D002836:Hemophilia B / Q000150:complications*; D006801:Humans; D016916:Joint Deformities, Acquired / Q000209:etiology / Q000601:surgery*; D007719:Knee Joint; D008297:Male
chemical_list: D005164:Factor IX