In spite all the measures, there would be cases in haemophilia where deformities would develop. Before surgical correction is taken nonoperative measures should always be employed.
Traction
In flexion deformities of the knee and hip, a period of continuous traction is effective in relieving muscle spasm and increasing range of motion. Initially traction forces are in the line of deformity and are gradually altered to achieve correction.
Prophylactic protection with antihemophilic factor is usually not required while the patient is in traction. Once a neutral or a nearly neutral position is obtained, well-padded plastic splints are used to maintain the part in the corrected position.
Active exercises are begun to increase muscle power and range of motion of the joints.
Plaster Cast
If functional range of motion is not achieved after two or three weeks of traction, a wedging cast is applied. The antihemophilic factor is administered when the cast is wedged.
When full joint motion is achieved the knee is immobilized for a period of seven to ten days and maintained in plastic splint
Physical therapy in the form of active exercises is begun and increased gradually.
If bleeding occurs during physiotherapy, it is controlled by intravenous administration of antihemophilic factor.
Forceful manipulation of a joint under general anesthesia is not recommended.
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