1. Perioperative management and outcome of fracture treatment in patients with haemophilia without inhibitors
- Author
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M. Müller, Andreas C. Strauss, Peter H. Pennekamp, R. Placzek, Christof Burger, Johannes Oldenburg, Jan Schmolders, and Max J. Friedrich
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,030204 cardiovascular system & hematology ,Haemophilia ,Hemophilia A ,Perioperative Care ,03 medical and health sciences ,Fractures, Bone ,Young Adult ,0302 clinical medicine ,Postoperative Complications ,Fracture Fixation ,Fracture fixation ,medicine ,Humans ,In patient ,Child ,Genetics (clinical) ,Aged ,Retrospective Studies ,Aged, 80 and over ,Perioperative management ,business.industry ,Significant difference ,Hematology ,General Medicine ,Length of Stay ,Middle Aged ,medicine.disease ,Fracture treatment ,Surgery ,Treatment Outcome ,Cohort ,Drainage ,Female ,business ,Complication ,030215 immunology - Abstract
Introduction Fractures in persons with haemophilia (PWH) are not uncommon and require an interdisciplinary approach to maintain haemostasis during surgical treatment. Aim The aim of this study was to evaluate the perioperative management and outcome in PWH following fracture fixation compared to a matched non-haemophilic control group. Methods A cohort of 44 PWH who underwent 46 surgical fracture fixations was retrospectively compared to 46 non-haemophilic patients (matched-pair controls). Patients were classified according to the fracture localization: (i) proximal upper extremity (PrUEx; n = 7), (ii) distal upper extremity (DiUEx; n = 12), (iii) proximal lower extremity (PrLEx; n = 13) and (iv) distal lower extremity (DiLEx; n = 14). Both groups were assessed for length of hospital stay, duration of surgery, drainage use and complication rates. Results There was no significant difference regarding the duration of the preoperative hospital stay between PWH and controls. Only PWH who were operated at the DiUEx stayed significantly longer in hospital (4.8 ± 3.7 days) than controls (2.2 ± 2.3 days; P = 0.039). Operation time was significantly longer in PWH with fractures treated at the DiLEx (64.9 ± 26.6 min) compared to the controls (49.8 ± 37.9 min; P = 0.035). Neither frequency nor duration of surgical drainage placement differed significantly between the two groups. The overall complication rate in both groups was low without a statistically significant difference. Conclusion An optimal interdisciplinary perioperative management provided the surgical treatment of fractures in PWH can be performed safely with a low complication rate.
- Published
- 2015