{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T04:54:59Z","timestamp":1790571299408,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Haemophilia"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Achilles tendon lengthening combined with external fixation (EF) has shown promising outcomes in managing haemophilia\u2010related Achilles tendon contracture.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To compare coagulation factor consumption and medium\u2010 to long\u2010term outcomes between Achilles tendon lengthening with and without EF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Clinical data between December 2012 and April 2023 were retrospectively analysed. Patients were divided into the traditional surgery (TS) group and the EF group based on the fixation method. Inter\u2010group comparisons were performed (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05 considered significant).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 10 patients completed follow\u2010up. The mean age was 25.8\u00a0\u00b1\u00a014.1\u00a0years, and the median follow\u2010up duration was 3.17 [1.78, 12.1]\u00a0years. During hospitalization, mean coagulation factor consumption was lower in the EF group (19.7\u00a0\u00b1\u00a011.9 vs. 31.5\u00a0\u00b1\u00a09.31\u00a0IU\/kg*day). One\u2010month post\u2010discharge, consumption was similar (25.2\u00a0\u00b1\u00a02.61 vs. 22.3\u00a0\u00b1\u00a01.06\u00a0IU\/kg*day). By the second month, the EF group showed lower consumption (14.3 [13.9, 23.8] vs. 22.6 [20.8, 23.1]\u00a0IU\/kg*day). Additionally, mean intraoperative blood loss was lower in the EF group (104\u00a0\u00b1\u00a0109 vs. 207\u00a0\u00b1\u00a0101\u00a0mL). The EF group required longer mean fixation times (99 [72.0, 104] vs. 44 [42.0, 54.0] days) and showed a higher complication rate (80%\u00a0vs. 40%), but all resolved or without impact on daily life. However, one case of contracture recurrence occurred in the TS group. Satisfaction and improvement rates were higher in the EF group (80%\u00a0vs. 60%). Only the difference in mean fixation time reached statistical significance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Achilles tendon lengthening with EF may be a safer and effective strategy for managing haemophilia\u2010related Achilles tendon contracture compared to TS. However, further studies are required to confirm these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hae.70166","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T13:26:04Z","timestamp":1763472364000},"page":"246-254","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Coagulation Factor Consumption and Medium\u2010 to Long\u2010Term Outcomes of Achilles Tendon Lengthening With and Without External Fixation in Haemophilia"],"prefix":"10.1111","volume":"32","author":[{"given":"Ze","family":"Chen","sequence":"first","affiliation":[{"name":"Division of Orthopaedics and Traumatology Department of Orthopaedics Nanfang Hospital Southern Medical University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guiyong","family":"Jiang","sequence":"additional","affiliation":[{"name":"Division of Orthopaedics and Traumatology Department of Orthopaedics Nanfang Hospital Southern Medical University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaowen","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Health Management Nanfang Hospital Southern Medical University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaxin","family":"Lv","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics &amp; Traumatology Li Ka Shing Faculty of Medicine The University of Hong Kong  Pokfulam Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haihao","family":"Liu","sequence":"additional","affiliation":[{"name":"Division of Orthopaedics and Traumatology Department of Orthopaedics Nanfang Hospital Southern Medical University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Orthopaedics and Traumatology Department of Orthopaedics Nanfang Hospital Southern Medical University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiyu","family":"Han","sequence":"additional","affiliation":[{"name":"The Tenth Affiliated Hospital (Dongguan People's Hospital) Southern Medical University Dongguan Guangdong China"},{"name":"Clinical Research Centre Zhujiang Hospital Southern Medical University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Orthopaedics and Traumatology Department of Orthopaedics Nanfang Hospital Southern Medical University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,18]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)02139-1"},{"issue":"7","key":"e_1_2_11_3_1","first-page":"1008","article-title":"Arthropathy of the Ankle in Hemophilia","volume":"73","author":"Gamble J. 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