Elective surgery in patients with congenital coagulopathies and inhibitors: experience of the National Haemophilia Centre of Venezuela.

Elective surgery in patients with congenital haemophilia with inhibitors carries a high risk of bleeding. However, inhibitor patients also have a high risk of haemarthroses and other orthopaedic complications, and surgery could improve their quality of life. Successful elective surgery has been reported in inhibitor patients under haemostatic cover with plasma-derived activated prothrombin complex concentrate (pd-aPCC) or recombinant activated factor VII (rFVIIa).

Radiosynoviorthesis in haemophilia: how safe?

One of the best procedures to prevent haemarthrosis in haemophilia has been radioactive synovectomy (radiosynoviorthesis). Since 1976 we have performed 119 radiosynoviortheses in 110 patients, aged from 3 to 40 years (mean 10), and of whom 71 were under 12 years of age. The knees were injected in 71, elbow in 29, ankles in 16, and shoulders in 3 cases.

Adductor myotomy in cerebral palsy: uni or bilateral.

Introduction: In patients with cerebral palsy, the prevention of hip dislocation should be the "primum momens" of early surgery. The surgery consists of a myotomy of the adductor medium, mayor and gracilis, and, in non-ambulatory cases, a neurectomy of the second branch of the obturator nerve. The purpose of this study was to examine whether the adductor myotomy should be performed on the contralateral side at one sitting.

Vascularised iliac graft as a method of acetabular augmentation in subluxed hip in adolescents.

This article presents the clinical experience of patients with a dysplasic subluxated hip treated with the same procedure involving a vascularised graft of iliac crest by sartorius muscle. This study was performed in three different centres, in two different countries, and in 31 patients with 37 hips (9 bilateral). All patients were clinically evaluated according to the Merle d Aubigne scale and radiological measuring of acetabular coverage, Sharp angle, and CE angle.