Rehabilitation management of a triceps surae muscle injury in a young male with haemophilia A and high-titre inhibitors

Rehabilitation management of a triceps surae muscle injury in a young male with haemophilia A and high-titre inhibitors

Authors

  • Antonio Frizziero Department of Medicine and Surgery, University of Parma, Parma, Italy
  • Paolo Finotti Department of Physical and Rehabilitation Medicine, University Hospital of Padua, Padua, Italy
  • Cosimo Costantino Department of Medicine and Surgery, University of Parma, Parma, Italy
  • Samantha Pasca Hemophilia Center, University Hospital of Padua, Padua, Italy
  • Ezio Zanon Hemophilia Center, University Hospital of Padua, Padua, Italy

Keywords:

haemophilia, intramuscular bleeding, management, rehabilitation

Abstract

Haemophilia A is a rare inherited hematologic disorder characterized by a deficit of coagulation factor VIII. It is associated with frequent episodes of musculoskeletal bleedings that occur mainly inside joints and secondly inside muscles. The majority of intramuscular hematomas respond well to conservative protocols, based on rehabilitation techniques and appropriate haemostatic coverage; surgery is limited to refractory cases. This manuscript describes the management of an intramuscular bleeding in a young patient with severe haemophilia A and high-titre inhibitors. A multidisciplinary approach directed by a physiatrist and combining surgical intervention, use of bypassing agents and rehabilitation treatment allowed to successfully managing this case, leading to a complete functional recovery. Given the lack of consensus on the treatment of intramuscular bleedings in haemophiliac patients, this case report provides an example of successful management for such conditions, which require a multidisciplinary approach in which the physiatrist plays a key role.

References

1. Valentino LA, Hakobyan N, Enockson C, et al. Exploring the biological basis of haemophilic joint disease: experimental studies. Haemophilia. 2012 May;18(3):310-8

2. Beyer R, Ingerslev J, Sørensen B. Current practice in the management of muscle haematomas in patients with severe haemophilia. Haemophilia. 2010 Nov;16:926-31

3. De la Corte-Rodriguez H, Rodriguez-Merchan EC. Treatment of muscle haematomas in haemophiliacs with special emphasis on percutaneous drainage. Blood Coagul Fibrinolysis. 2014 Dec;25(8):787-94

4. Koh ES, McNally EG. Ultrasound of skeletal muscle injury. Semin Musculoskelet Radiol. 2007 Jun;11(2):162-73

5. Rodriguez-Merchan EC. Aspects of current management: orthopaedic surgery in haemophilia. Haemophilia. 2012 Jan;18(1):8-16

6. Maffulli N, Oliva F, Frizziero A, et al. ISMuLT Guidelines for muscle injuries. Muscles Ligaments Tendons J. 2014 Feb 24;3(4):241-9

7. Smith TO, Hunt NJ, Wood SJ. The physiotherapy management of muscle haematomas. Phys Ther Sport. 2006 Nov;7(4):201-9

8. Sørensen B, Benson GM, Bladen M, et al. Management of muscle haematomas in patients with severe haemophilia in an evidence-poor world. Haemophilia. 2012 Jul;18(4):598-606

9. Beeton K, Rodriguez-Merchan EC, Alltree J, Cornwall J. Rehabilitation of muscle dysfunction in hemophilia. Rev. ed. World Federation of Hemophilia. 2012. 12 p. (Treatment of Hemophilia; No. 24)

10. Gomis M, Querol F, Gallach JE, Gonzalez LM, Aznar JA. Exercise and sport in the treatment of haemophilic patients: a systematic review. Haemophilia. 2009 Jan;15(1):43-54

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Published

30-04-2021

How to Cite

1.
Frizziero A, Finotti P, Costantino C, Pasca S, Zanon E. Rehabilitation management of a triceps surae muscle injury in a young male with haemophilia A and high-titre inhibitors. Acta Biomed [Internet]. 2021 Apr. 30 [cited 2024 Oct. 5];92(S1):e2021118. Available from: https://www.mattioli1885journals.com/index.php/actabiomedica/article/view/10983