Case report: Resection and reconstruction of a massive femoral hemophilic pseudotumor

Jacob M. Buchowski, Brett M. Cascio, Michael B. Streiff, Frank J. Frassica

Research output: Contribution to journalArticle

Abstract

Hemophilic pseudotumor is a rare, but well-known, complication of hemophilia. We describe a 50-year-old man with mild hemophilia A, but with no previous need for Factor VIII supplementation, who presented with a pathologic fracture of the right femoral neck and shaft caused by a large hemophilic pseudotumor. Initial nonoperative therapy with factor replacement and skeletal traction resulted in radiographic evidence of fracture healing, but the patient's pain persisted. Therefore, he had a radical resection of his hemophilic pseudotumor (soft tissue component and entire femur), and reconstruction with a custom total femoral replacement. Six months after resection, the patient returned to full-time employment. Although pseudotumor formation is a well-recognized complication of hemophilia, the pseudotumor in our study is one of the largest yet described. More importantly, to our knowledge this is the first report of a pseudotumor treated by radical resection and reconstruction with a custom femoral prosthesis. We think that radical resection and reconstruction with a custom total femoral prosthesis is a valuable alternative to amputation in massive pseudotumors of the femur and soft tissues of the thigh.

Original languageEnglish (US)
Pages (from-to)237-242
Number of pages6
JournalClinical orthopaedics and related research
Issue number430
DOIs
StatePublished - Jan 2005

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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