A 28-year-old man with hemophilia B, after falling down and striking his right thigh, was admitted to our hospital complaining chiefly of an inability to walk. On the physical examination, the mid-portion of his right thigh was spindle-shaped, tense, and swollen. The X-ray film revealed a pseudotumor and a fracture of the right femur. The patient didn't wish to have an operation and was therefore placed in skin traction for about 10 months under adequate replacement therapy for Factor IX using less than the standard minimam dose. Disarticulation of the right hip using Boyd's method was performed on February 17, 1978. The wound healed faster than expected under replacemtnt therapy of PTC during and after surgery PTC activity was frequently measured and no serious complications developed. The patient is now undergoing gait training, using a Canadian Hip. This case would indicate that any operation on hemophiliacs can be performed using adequate replacement therapy.
