Affiliation:
1. Department of Orthopaedic Surgery, La Paz University Hospital-IdiPaz, Paseo de la Castellana 261, 28046-Madrid, Spain
Abstract
Prevention is essential for avoiding the complications of muscle hematomas (compartment
syndrome, pseudotumors and peripheral nerve lesions) in hemophilic patients. This is
achieved through early diagnosis of muscle hematomas and proper long-term hematological treatment
until they have resolved (confirmed by image studies). Ultrasound-guided percutaneous drainage
could be beneficial in terms of achieving better and faster symptom relief. Acute compartment
syndrome (ACS) requires emergency surgical treatment (decompression fasciotomy). As for
pseudotumors, the biopsy will help us confirm the diagnosis and rule out true tumors (chondrosarcoma,
liposarcoma, synovial sarcoma) that sometimes mimic hemophilic pseudotumors. Surgical
removal of hemophilic pseudotumors is the best solution. As alternatives, there are curettage and
filling with cancellous bone and radiotherapy (when surgery is contraindicated). Preoperative
arterial embolization (ideally 2 weeks before surgery) helps control intraoperative bleeding during
surgery for giant pelvic pseudotumors. Peripheral nerve injuries, which are rare, almost always occur
due to compression of hematomas in the vicinity. In most cases, they usually resolve with hematological
treatment only. If such treatment fails, surgery would be indicated.
Publisher
Bentham Science Publishers Ltd.
Subject
Cardiology and Cardiovascular Medicine,Pharmacology,Hematology,Molecular Medicine,General Medicine
Cited by
7 articles.
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