IIlizarov external fixator for bilateral severe flexion deformity of the knee in haemophilia: case report

Abstract

Introduction

Deformity correction by Illizarov method in haemophilic patients is a rare phenomenon.

Aim

To correct the bilateral knee deformity by Illizarov in one sitting.

Materials and methods

Patient had fixed flexion deformity (100°) 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.

Result

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° with 5° 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.

Conclusion

Illizarov method is a safe, less invasive, effective, economical and truly biological method for correction of severe flexion deformities of knee in haemophilic patients.