did parihar break the bones too high?

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Quote from: Tartar on May 17, 2021, 02:10:59 PMYou have a good eye. He performed an higher one. Giotikas too is used to do it sometimes.
Nuvasive recommends a lower osteotomy, some cms under the trochanter. Not a big deal anyway, but these are indications of the company.

Hi Tartar, are you a Giotikas patient? Did he change his ways now or does he still do proximal osteotomies? And do you have a source from nuvasive about this or did giotikas tell this to you?

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Quote from: analyser on May 17, 2021, 01:20:35 PMDo you have a source for this?

Every surgeon is going to have their own preference.

This is what Dr Franz Birkholtz (https://www.emedevents.com/speaker-profile/franz-friedrich-birkholtz) said about proximal osteotomies:

http://www.limblengtheningforum.com/index.php?topic=137.msg65429#msg65429

Quote"1) Is the placement of the break relevant in regards to recovery or even the look of the soft tissue surrounding it? For example, if one was to break and lengthen the center of the calf muscle vs just above the ankle.

Yes,absolutely. The choice of osteotomy site will determine the rate and quality of bone growth, as well as the final appearance of the limb. As a general rule, the preference in the femur is proximal. In the tibia we also prefer proximal as that creates the most reliable bone formation."

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I think its 1/3 of the way down the guidelines are , or its half way, can't remember

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He straight up fractured that guy’s femur with a hammer. There are actual fragmented bone shards in that X-ray. 🤯🤯🤯

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oh i see what you mean ya

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Quote from: PerfectBody on May 18, 2021, 07:50:24 AMHe straight up fractured that guy’s femur with a hammer. There are actual fragmented bone shards in that X-ray. 🤯🤯🤯

A shattered break during osteotomy is not uncommon, and patients with solid bone density will tend to shatter at the osteotomy site instead of being able to cut cleanly. This isn't a bad thing, and many surgeons will actually perform an osteotomy like this on purpose because it creates more surface area to promote bone growth.

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Quote from: KiloKAHN on May 18, 2021, 08:19:34 AMA shattered break during osteotomy is not uncommon, and patients with solid bone density will tend to shatter at the osteotomy site instead of being able to cut cleanly. This isn't a bad thing, and many surgeons will actually perform an osteotomy like this on purpose because it creates more surface area to promote bone growth.

While I agree I've read similar things before, I see no surgeon intentionally creating an osteotomy like this. Not Paley, not any of the US surgeons who are known for LL.

In Penguinn's case, it is understood that it unintentionally turned out this way because the nail had to be reinserted.

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Quote from: KiloKAHN on May 17, 2021, 10:19:53 PMEvery surgeon is going to have their own preference.

This is what Dr Franz Birkholtz (https://www.emedevents.com/speaker-profile/franz-friedrich-birkholtz) said about proximal osteotomies:

http://www.limblengtheningforum.com/index.php?topic=137.msg65429#msg65429

Maybe so, but if it's a Precice thing, it's something the surgeon should change his approach just for the nail.

The unknown now is whether Nuvasive officially recommends more distal osteotomies. I will see if I can get an answer somehow.

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Quote from: analyser on May 18, 2021, 09:39:19 AMMaybe so, but if it's a Precice thing, it's something the surgeon should change his approach just for the nail.

The unknown now is whether Nuvasive officially recommends more distal osteotomies. I will see if I can get an answer somehow.

Dr Parihar's other Precice patients appear to be just fine. I think you're worrying too much, dude.

 

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Quote from: KiloKAHN on May 18, 2021, 10:36:05 AMDr Parihar's other Precice patients appear to be just fine. I think you're worrying too much, dude.

 

There is only one Dr Parihar Precice diary here. Are you sure these are his patients?

But yeah, it is done more distally in these.