
treatment and prevention of chronic haemorrhagic
arthropathy and contractures in haemophilia
orthopaedic treatment of joint deformities in thirteen patients with
haemophilia is reviewed over a period of seven years.
forms of treatment discussed include open operation, manipulation under general
anaesthesia, continuous traction, splintage and physiotherapy.  the amount of
intravenous therapy required for each form of treatment is indicated.
in discussing prevention of joint deformity the histories of a further eighteen
patients have been taken into account.  it is concluded that initially painless
haemarthroses provide the main threat to joint deformity in haemophilia.
the best preventive treatment is early immobilisation followed by prolonged
splintage and physiotherapy; intravenous therapy with antihaemophilic factor
plays a less important role here than in other forms of haemorrhage.
evidence is presented that joint deformity in severe haemophilia can often be
entirely avoided.
