Background Hemophilic pseudotumor (HPT)-related fracture is a rare but severe complication in patients with HPTs. These fractures often occur in femurs. There is no consensus on the standard surgical protocol for HPT-related femoral fracture. The present retrospective study evaluated the outcomes of these patients treated with surgical interventions. Methods Ten patients with HPT-related femoral fractures who were treated with 14 surgical procedures due to 11 fractures in our hospital from January 2014 to April 2020 were evaluated retrospectively. Demographic data, fracture location, complications after surgery, and follow-up outcomes were recorded and analyzed. The mean follow-up period was 39.7 months. Results The mean age at surgery was 31 years. Closed reduction external fixation (CREF) was originally performed in 2 patients, open reduction internal fixation (ORIF) was performed in 4 patients, screw fixation alone was performed in 1 patient, brace immobilization was performed in 1 patient, and amputation was performed in 3 patients. Bone union was observed in 5 patients, and an adequate callus was visible in 2 patients. Both patients with CREF had pin infections. Nonunion combined with external fixation (EF) failure occurred in 1 patient, and the plate was broken after ORIF. Three patients underwent autogenous or allogeneic cortical strut grafting. Three patients had HPT recurrence. Conclusions It is necessary to perform surgery in patients with HPT-related femoral fractures. Surgical treatments must consider fracture stabilization and HPT resection. Internal fixation is preferable, and EF should only be used for temporary fixation. If the HPT erodes more than one third of the bone diameter, strut grafts are necessary for mechanical stability. Amputation is an appropriate curative method in certain situations.

A pseudotumour is a very rare but serious complication of haemophilia. The prevalence of a pseudotumour in severe haemophilia is 1%-2% but can be up to 10% in haemophilic patients with coagulation inhibitors.. 1 Pelvic haemophilic pseudotumour is essentially chronic fibroproliferative inflammation of the pelvic and abdominal cavity. It initially manifests in soft tissue and then gradually erodes bone tissue. Pelvic haemophilic pseudotumour is characterized by multiple arterial supplies, is expansive, painless and adheres to deep tissues, resulting in poor mobility. Spontaneous rupture, infections, pathological fractures or fatal bleeding may occur as the lesions progress. 2 Treatment of a pelvic pseudotumour depends on its location, size, growth rate and impact on surrounding tissues. Current treatments

Highlights Brain abscess in patients with Eisenmenger syndrome is extremely rare. It’s is important to understand and prevent this potentially fatal syndrome. Perioperative management is an important steps. Long-term targeted antibiotic therapy can minimize the risk of abscess recurrence. During surgery, we recommend ensuring that intraoperative blood loss is minimized.