Quote from: Jim_dabarber on December 04, 2017, 01:03:15 PMhttps://imgur.com/gallery/YypeM
First xrays after surgery
This is the weirdest bone break I ever saw.
It is not a straight cut but a Z one? Isn't the bone very prone to premature consolidation with a cut like that?
I am not sure if it will cause anything bad but for sure this cut is not usual. I never saw any respectable doctor doing that kind of cut.
Also, on your femurs you have a modified Ilizarov? Why not a monorail? Anything external on femurs is a bad idea but Ilizarov is way too barbaric and also causes extreme problems on knee rom.
Anyway, in your surgery everything is too extreme to cope with.
But please ask your doctor why he did that kind of cut and why he didn't prefer a straight cut as most doctors do.
Cross lengthening in st petersburg russia
Quote from: Body Builder on December 04, 2017, 01:48:07 PMThis is the weirdest bone break I ever saw.
It is not a straight cut but a Z one? Isn't the bone very prone to premature consolidation with a cut like that?
I am not sure if it will cause anything bad but for sure this cut is not usual. I never saw any respectable doctor doing that kind of cut.
Also, on your femurs you have a modified Ilizarov? Why not a monorail? Anything external on femurs is a bad idea but Ilizarov is way too barbaric and also causes extreme problems on knee rom.
Anyway, in your surgery everything is too extreme to cope with.
But please ask your doctor why he did that kind of cut and why he didn't prefer a straight cut as most doctors do.
The first pic is a S-osteotomy. It increases the surface of bone contact and as such should decrease healing time. Premature consolidation is very rarely a problem for tibia lengthening, all it should do for him is make him heal faster.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3779558/
QuoteExternal fixation index in group A (21.02 ± 3.16 days/cm) was significantly lower than that in group B (76.19 ± 8.32 days/cm; P < 0.05). Consolidation index was significantly lower (more rapid healing) in group A (43.38 ± 5.35 days/cm) than that in group B (76.19 ± 8.32 days/cm; P < 0.05). Quote In group A, 78 tibial lengthenings were performed with longitudinal S-osteotomy and LATN technique. In group B, 98 tibial lengthenings were performed with the classic method.
QuoteConclusion
The novel method combined longitudinal S-corticotomy and LATN technique safely reduces the consolidation time, rate of pin-tract problems and axial deviation during leg lengthening, compared with the classic Ilizarov method.
Quote from: Overdozer on December 04, 2017, 06:06:49 PMThe first pic is a S-osteotomy. It increases the surface of bone contact and as such should decrease healing time. Premature consolidation is very rarely a problem for tibia lengthening, all it should do for him is make him heal faster.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3779558/
I was almost healed at 6 cm with 0.66mm lengthening oer day and I increased to 1mm up to 7.5 (thats why I had bf problem).
And I had a straight cut.
So yes, if that S cut don't lead to premature consolidation it will help with faster bine healing.
But I really think that it may cause premature consolidation because most of the sides are almost touch each other.
Anyway we'll see. But I've never seen any respectable doctor using that cut.
S-cut is practiced in the Slavic countries. Mirzoyan uses it.
There is really no need for it no.
Quote from: Body Builder on December 04, 2017, 08:43:20 PMI was almost healed at 6 cm with 0.66mm lengthening oer day and I increased to 1mm up to 7.5 (thats why I had bf problem).
And I had a straight cut.
So yes, if that S cut don't lead to premature consolidation it will help with faster bone healing.
But I really think that it may cause premature consolidation because most of the sides almost touch each other.
Anyway we'll see. But I've never seen any respectable doctor using that cut.
Quote from: FDR101 on December 04, 2017, 01:43:35 PMGood luck Jim, cross lengthening is extreme in my opinion, but you took a good decision in choosing moderate amount of 4 cm over both segments.
From what I understand you plan on lengthening at home. Have you organized PT's and a plan for recovery training? Remember although it is going to be a very hard journey, it is vital that you keep up the training of your legs.
Best of luck, keep up us updated. 4 cm lengthening should take less than 2 months if you go for 0.81mm a day, so just stay strong!
Exactly why i decided to only do 4cm across all four segments. Proportions and tissue muscle recovery ade important to me. I have an orthopedic near my hometown who will continue the treatmeant. I am from florida so finding reputable orthopedics who would take my health insurance was not hard. At the moment i havent discussed the pt plans yet. He wasnts to see me in person and figure out where we are and what our approach will be. I will be doing .80mm a day on my tibia where as my femur i will be doing 1.15mm per day depending on callus formation and to not have preconsolidation.
Thank you!
I discussed the use of z-shaped osteotomy of tibia with dr kulesh and he explained that it helps reduce the possibility of non-union or mal-union formation.
Today i finally started distraction! Tibia was pain free as expected. Once i got to the the femur thats when reality sunk in. This is deffiniately not going to be a walk in the park but its doable. Pain for tibia 1/10 more discomfort than pain. Pain for femur 6/10. Big difference! But once again. Very doable and at my budget i think i made a great choice. People on this forum will bash and talk trash about peoples desicions but at the end of the day this forum is to share personal experiences hands on. Everyone has their entitlement to opinion but unless youve gone thru the process and pain theres no way you can judge on any of their actions. I will and i know i can get thru this.
Hi there,
I have a few questions for you. I hope you could share some info as I am finalizing my LL plans, which I will do this coming summer!
- Who was your surgeon? Was it Solomin or Kulesh? I'm really confused on how their partnership works.
- Did you have the option to choose one of them?
- How are the doctors treating you so far?
- How is the quality of MEDEM?
- How hard and how long was the visa process? I'm from North America as well (USA/Canada).
- What was your method of payment? wire transfer, credit card, or cash?
Your responses will be greatly appreciated. 
I wish you the best bro.
Quote from: Jim_dabarber on December 06, 2017, 08:50:55 AMI discussed the use of z-shaped osteotomy of tibia with dr kulesh and he explained that it helps reduce the possibility of non-union or mal-union formation.
Today i finally started distraction! Tibia was pain free as expected. Once i got to the the femur thats when reality sunk in. This is deffiniately not going to be a walk in the park but its doable. Pain for tibia 1/10 more discomfort than pain. Pain for femur 6/10. Big difference! But once again. Very doable and at my budget i think i made a great choice. People on this forum will bash and talk trash about peoples desicions but at the end of the day this forum is to share personal experiences hands on. Everyone has their entitlement to opinion but unless youve gone thru the process and pain theres no way you can judge on any of their actions. I will and i know i can get thru this.
Why do you think there is such a pain difference between femurs and tibias.
Are the pins causing the trouble (because femurs are encircled with much bigger muscles than tibias) or the cut causes more pain on femurs compared to tibias?
My tibia LL was almost painless as you described but most LLers with internal on femurs didn't described much pain too. Thats why I wonder if the Ilizarov is what gives you pains in femurs.
Quote from: Tiny on December 06, 2017, 09:04:42 AMHi there,
I have a few questions for you. I hope you could share some info as I am finalizing my LL plans, which I will do this coming summer!
- Who was your surgeon? Was it Solomin or Kulesh? I'm really confused on how their partnership works.
- Did you have the option to choose one of them?
- How are the doctors treating you so far?
- How is the quality of MEDEM?
- How hard and how long was the visa process? I'm from North America as well (USA/Canada).
- What was your method of payment? wire transfer, credit card, or cash?
Your responses will be greatly appreciated. I wish you the best bro.
-My main surgeon who i have always been in touch and guided me through all this has been Dr. Kulesh although during the operation they were both precent. Dr Solomin was the one who inserted the LON nail on my femur while Kulesh performed all the other stuff.
-Yes i had the option to choose between either one but obviously Dr Solomins price was way higher than Dr Kulesh and so i decided to go along with Kulesh and i was confindent since hes been working along side Solomin for 10+ years that hes highly trained.
- The doctors are good. They all speak english so if you have any questions or concerns you can can always reach out to them. Dr Kulesh is always an email away and responds fairly quickly.
- i actually decided on getting operated at the municipal clinic which is st elizabeth as the cost was way lower and they had availailable spots. Dr kulesh sent out an asstant to pick me up from my hotel that morning and he was in charge of translating and helping me get around the hospital. After i got situated he left and the aenesthesia guy came in along with the gp doctor who both understand good english and explained the rest for me. The nurses and other staff have no idea how to speak english but im getting along just fine with a translating app that i downloaded before coming and if any qs i just call Dr kulesh and he speaks for them.
- The visa process took aproximately 3 weeks in total but i had everything expidited and paid extra just incase. Im sure the regular time frame for visa is around 5-6 weeks. It was actually really easy to aquire with the agency that Dr Kulesh recomended me with.
- I honestly just brought $5k cash and hid it in my pants the whole time here. Omce here i just simply went to a local bank and changed currencies although Dr Kulesh did say i could wire the money but then you would have to have somebody from your country doing all that for you and to me it was just too much of a hassle. I believe he doesnt accept credit card payments. Never really ask him. But i could if yould like?
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