There have only been a few studies in the literature which reported on the outcome of ankle arthrodesis in patients with hemophilia, furthermore the number of patients is usually low and the operative technique is not uniform. The aim of this study is to evaluate the outcome of surgery in hemophilic arthropathy of the hindfoot, using internal fixation.

From 1983 to 2006, 20 fusions were performed in 13 consecutive patients due to advanced hemophilic arthropathy of the hindfoot. There were 11 ankle fusions, 1 isolated subtalar fusion and 8 ankle and subtalar fusions, 3 of the latter on a second operation. The mean age at operation was 38.7 years and the mean followup was 9.4 years. Preoperativelly the mean modified Mazur score was 47.7. In the majority of cases the ankle fusion was achieved by two crossing screws, while, for the subtalar fusion either staples were used, or the tibiotalar screws were extended to the os calsis.

Arthrodesis of the ankle was successful in all but one patient, who was revised and progressed to fusion. The mean postoperative modified Mazur score was 94.9. There was also one painless incomplete union of the subtalar joint which did not need revision. There was no recurrent bleeding, and no deep infection.

Arthrodesis with cross screw fixation and staples is a quick, simple and effective method for fusion of the hindfoot in patients with hemophilia.