Therapeutic options in the management of articular contractures in haemophiliacs

Ec, Rodríguez-Merchán

doi:10.1046/j.1365-2516.1999.0050s1005.x

Cited by 45 publications

(25 citation statements)

References 9 publications

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“…In previous studies, we have found that osteotomy of hemophilic knee and hip joints did not necessarily prevent further destruction (Wallny et al 2002(Wallny et al , 2003. Furthermore, untreated or only non-operatively managed equinus deformities also show progressive arthropathy (Rodriguez-Merchan 1999). It therefore seems that with or without surgical management, deterioration of the ankle joint is inevitable-and is most likely not a result of Achilles tendon lengthening.…”

Section: Discussionmentioning

confidence: 96%

Achilles tendon lengthening for ankle equinus deformity in hemophiliacs: 23 patients followed for 1–24 years

et al. 2006

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Background Bleeding in the calf or ankle joint may lead to ankle equinus deformity, particularly in childhood and during adolescence. We assessed the longterm functional and radiographic results after Achilles tendon lengthening for ankle equinus deformity in hemophiliacs.Patients and methods Between 1975 and 1986, 30 hemophilic patients with pes equinus were surgically managed by Achilles tendon lengthening. Of these, 23 were followed up prospectively twice a year for an average of 13 (1-24) years. The mean age at operation was 29 (12-46) years. The clinical results were documented according to the score of the Advisory Committee of the World Federation of Hemophilia (WFH), while radiographs were evaluated using the Pettersson score. On average, preoperative ankle equinus deformity was 21 (5-55) degrees. Mean range of motion was 21 (5-42) degrees prior to surgery.Results At the first postoperative examination 1 year after surgery, 21/23 cases were improved, and 9/21 reached dorsiflexion to at least neutral position. At the last follow-up, ankle equinus deformity was 10 (4-20) degrees on average. 20/23 patients still showed significant improvement compared to their condition before surgery. 7 patients still had complete correction of the equinus deformity, while mean range of motion decreased constantly over the observation period. The clinical score was significantly improved 1 year after surgery and diminished only slightly afterwards. Radiographic outcome deteriorated, with scores rising from 4.3 (1-10) points preoperatively to 7.3 (3-12) points at last follow-up.

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Section: Discussionmentioning

confidence: 96%

Achilles tendon lengthening for ankle equinus deformity in hemophiliacs: 23 patients followed for 1–24 years

et al. 2006

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“…Casting often results in a reduction in the available ROM due to prolonged immobilisation (Rodriguez-Merchan, 1999). Disuse atrophy or a reduction in the strength of the thigh muscles is one of the commonest complications of this procedure.…”

Section: Plaster Of Paris Serial Casting or Wedge Castingmentioning

confidence: 99%

“…Patients with skin traction or reverse dynamic traction are often restricted to bed until the traction is applied (Rodriguez-Merchan, 1999).…”

Section: Skin Tractionmentioning

confidence: 99%

“…Most of the splinting methods commonly used have disadvantages, however. Static splinting, especially in the form of plaster casting, leads to a reduction in the range of movement (ROM) and muscle strength due to prolonged immobilization (Rodriguez-Merchan, 1999). Traction techniques restrict the patient to bed and necessitate hospitalization.…”

Section: Introductionmentioning

confidence: 99%

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MYNI's traction: a reverse dynamic traction and concomitant ambulatory aid for patients with knee flexion deformities

Manigandan

Kumar²,

Bedford³

et al. 2007

International Journal of Rehabilitation Research

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Fixed flexion deformity of the knee is one of the commonest deformities that occur as a secondary complication of various knee arthropathies. In developing countries such as India, where walking is the primary, preferred and most feasible mode of transport, the secondary complications following a fixed flexion deformity of the knees pose a serious threat to functional independence. External splinting techniques have been in use for many years for preventing and correcting fixed flexion deformities, but most of the splinting methods commonly used have disadvantages. Static splinting leads to a reduction in the range of movement and muscle strength due to prolonged immobilization; traction techniques restrict the patient to bed and necessitate hospitalization. Wedge casting can lead to a posterior subluxation of the tibia when used over a long period. Thus, the idea was to design an orthosis that serves the purpose of improving knee range of movement without the above-mentioned complications, at the same time being portable and comfortable to the client, concomitantly allowing them to be ambulant. Accordingly this article presents a new method in splinting that helps in these multiple ways.

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“…Replacement therapy with recombinant factor VIII or IX is the first and essential step in the treatment of hemarthrosis [5]. Physical therapy interventions have a fundamental and an efficient role in the rehabilitation of these patients [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

LASER versus electromagnetic field in treatment of hemarthrosis in children with hemophilia

Eid

Aly

2015

Lasers Med Sci

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Children with hemophilia usually have recurrent joint bleeding that leads to joint damage, loss of range of motion, and restriction of mobility, therefore affecting the quality of life in these children. The purpose of this study was to compare the effects of lowlevel laser therapy (LLLT) to that of pulsed electromagnetic field (PEMF) in treatment of hemarthrosis in children with hemophilia. Thirty boys with hemophilia A with ages ranging from 9 to 13 years were selected and assigned randomly, using sealed envelopes, into two equal intervention groups. The study group I received the traditional physical therapy program in addition to LLLT, whereas the study group II received the same physical therapy program given to the study group I in addition to PEMF. Both groups received the treatment sessions three times per week for three successive months. Pain, laboratory investigations, swelling, and range of motion (ROM) of the affected knee joint, in addition to physical fitness were evaluated before, at the end of the sixth week and at 12 weeks of the treatment program. Laser group showed significant improvement in all measured variables after the sixth week of treatment when compared with PEMF. By 12 weeks of treatment, there was a significant improvement in pain, ROM, ESR and leucocytes levels in laser group compared with PEMF, while there was no significant difference in knee circumferences and the 6-min walk test (6MWT) between both groups. Both groups showed significant improvement at 12 weeks of treatment compared with that at 6 weeks. Both LLLT and PEMF are effective modalities in reducing pain, swelling, increasing ROM and improving physical fitness. Twelve weeks of treatment of both modalities demonstrated significant improvement than 6 weeks of treatment. Laser therapy induced significant improvement than electromagnetic therapy in treatment of hemarthrosis-related problems in children with hemophilia.

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Therapeutic options in the management of articular contractures in haemophiliacs

Cited by 45 publications

References 9 publications

Achilles tendon lengthening for ankle equinus deformity in hemophiliacs: 23 patients followed for 1–24 years

Achilles tendon lengthening for ankle equinus deformity in hemophiliacs: 23 patients followed for 1–24 years

MYNI's traction: a reverse dynamic traction and concomitant ambulatory aid for patients with knee flexion deformities

LASER versus electromagnetic field in treatment of hemarthrosis in children with hemophilia

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