Lower Extremity Microsurgery in a Patient With Combined Sickle Cell Disease and Hemophilia: A Case Report and Literature Review

The combination of hemophilia and sickle cell disease poses unique challenges in the perioperative management of patients requiring free tissue transfer (FTT). Extremity FTT requires mitigation of risk factors related to perioperative bleeding and microvascular thrombosis. This case report highlights the nuances of managing an open ankle fracture in a patient with both sickle cell trait and severe hemophilia A. The narrative and discussion highlights the importance of a multidisciplinary team with regard to executing a limb salvage plan in the setting of complex medical decision-making.