Intramuscular Hemorrhage in Hemophiliacs With Inhibitors

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Abstract
Any hemorrhage in a hemophilic patient must be regarded as a serious problem. A small percentage of hemophiliacs have an inhibitor that will destroy factor VIII or IX clotting activity, thus making control even more difficult. This occurrence predisposes these patients to joint contractures and deformities secondary to repeated, uncontrolled hemorrhages into muscle compartments and joints. Patients with an inhibitor must, therefore, be recognized, and any bleeding should be treated as an emergency. A combined treatment protocol has been developed by the hematology and orthopedic departments in a effort to achieve early hemorrhage control and prevent subsequent deformity. (JAMA241:2028-2030, 1979)