Dr. Alexander Kirienko (Milan, Italy) - Ilizarov Tibia

Hello
I'm a 1,62cm guy from Rome, italy. Probably one of the shortest here. My goal is to reach 168cm (I know it's still short but it's more frequent among the population than 162, at least in central-southern italy)
So my goal is to lenghten 6 or 6.5 cm.

My doctors said that theoretically it's possible to reach 8 cm but it depents on the patient. It also suggested me to not go beyond 6, maximum 7 cm because I have short arms.

I had surgery with doctor Kirienko on october 11 of this year at Humanitas Research Hospital of Rozzano (Milan, Italy). The cost was 22k euros.
X-ray follow ups every 2 weeks at "Villa Stuart" in Rome.

Lenghtening started on october 16 a 1mm/day. I'm currently at 4cm and some minor bone callus startes showing up. The knee and ankle starts to oppose resistance. Especially knee extension is hard, but I reach full 180 degrees with stretching. I *should* reach 6 cm easily since there are still no clinically relevant contractures.

Only had on minor complication: slight procurvatum on left tibia. Doctors says it can happen because the gastrocnemius muscles push the tibia from behind. After the lenghtening ends, it will be easily solved by adjusting the proximal ring of the fixator by using hinges. No need for surgery thanks to the ilizarov apparatus.

Feel free to ask any question

Just classic circular external frames, nothing internal.

sure, but I only have printed version from 2 weeks ago x-rays, at about 2,5cm and still no callus.
As soon as I get the new one printed from the clinic (I couldn't yesterday because I had another appointment later I will also post them)

Quote from: saltedchocolate on November 26, 2023, 02:58:55 PMdo you mind uploading your x-rays?

Here you go, these are from 2 weeks ago.
Sorry for the quality but by pc doesn't have a cd reader

You can see in the first image a slight procurvatum deformity. This should be fixed easily thanks to the hinges already attached to the fixator.
The cut is not clean probably because the didn't use the saw but rather the classic osteotome. His assistant told me that the saw generates too much heat.
Doctor says it's all good except for the procurvatum.

 

My main problem as of now is knee extension so i'm doing a lot of physical therapy (3 time a week + stretching when I'm alone). Sometimes I have burning sensation on my foot and ankle but it passes if I take tramadol.

I won't go over 7cm, probably neither over 6.5. My doctor said that in theory you can lenghten up to 8cm but it depends on the patient and I also have short arms so He discourages me to go over 6-7.
He says that from 5 to 6 is hard, 6 to 7 is harder and 7 to 8 really hard.

Quote from: Beemer m3 on November 28, 2023, 04:28:45 AMi got short arms too. if i do my femurs i'll get to 175 cm . ill be average height . dream height but with short arms. it should be ok really. some guys do quadrillateral legthening and i doubt there arms are long enough. i would forget about the arms and grow the legs another cm if ur close to 170 cm u would feel more confident for sure.

Proportions is not the only limit but also knee and ankle contractures which are commonly seen over 5cm.

I do the lengthening by myself by adjusting some bolts 4 time/day.
I go to villa stuart every 2 weeks (even if I’ve been operated in milan because the surgery was less expensive there) just for xrays and doctor appointments. The Doctor check my xrays, ability to stand and walk, ability to extend the knee and flex the ankle and so on.
You don’t need to do physical therapy at villa stuart, every physiotherapist should do the work.

I choose a physiotherapist that comes to my home 3 times/week as suggested by the doctor. I need to walk and bear weigt a lot with the help of the physiotherapist because weight bearing stimulates bone growth. I also need to do stretch my knee and ankles a lot, even when I’m alone.
My foot is always flexed to prevent equinous. My knee should always be flexed but I can’t bear the pain especially when trying to sleep at night, so I sleep with flexed legs. Doctor says it’s ok IF I do a lot of stretching during the day with and without the physiotherapist.

Edit: here you have a photo of my fixators

 

When I go to villa stuart waiting for my appointment everyone has at least one fixators. Mostly in one leg. Two legs is mostly for cosmetic reasons ( height or deformities  ). Just one patient asked me if I had a car accident. I said “no” and the conversation stopped there.
My classmates at university know about everything because I made some instagram stories. I don’t care what people think and I thought it could be interesting especially because we are medical students.

I have 4 large pins for every leg. 2 near the knee and 2 near the ankle. And about 10 small pins, 5 near the knee and 5 near the ankle. My fixator only has 2 rings as you can see in the photo.

I'm feeling not very well because I'm stuck at home. It's more a psychological thing rather than pain. But it's a trade off to be taller.

Quote from: TheDream on November 28, 2023, 08:03:23 PMRespect for your courage and ability to organize the whole thing yourself.

I thought this was the standard. Do many other surgeons offer to stay at the clinic for the whole lenthening process? I think it’s better to stay at home. At least I have my pc