I did 8.0 cm LATN on tibias in 2016......AM(a)A : Ask Me (almost) Anything

Edit Post

Quote from: doomsday on June 26, 2017, 06:11:10 PMSibirsky have you got any xrays?

Yes I do but you need to be specific what kind of X-Rays you want. Too many for me to post at random so I prefer uploading based on request

Edit Post

Quote from: Bron on June 26, 2017, 06:39:14 PMSibirsky,

I have read it, thanks for your answers!

You're welcome! Glad to be of help

Edit Post

Hey guys I have some X-rays you may be interested in. Here's my X-rays taken when I was having correction done just before nailing

https://imgur.com/a/IonoC

Edit Post

....and here are X-rays taken post nailing. This angle should be able to reveal certain things you may want to consider.

https://imgur.com/a/Ablts

Firstly the nail is intentionally sticking out of the bone. This is to allow removal later on, though it makes kneeling uncomfortable at times but not downright painful. Secondly there are multiple screws that are keeping the nail in place. These nails are quite large and can actually be felt on the surface through the skin, but only the screw head not sharp pin part. They also don't hurt unless you hit them against something like a car dashboard (which I have several times). Then they'll hurt like a muthafuka 

Feel free to post questions and requests!

Edit Post

good consolidation for tibias but yeah quite unusual for the nail to stick out. I guess it makes no difference  as long as you dont hit that sticking out part. Did you get any recent xray to see progressing consolidation ?

edit

The doc knew his stuff. You had the hexapod frame , the same used by Dr daghoon Lee.

Edit Post

Quote from: doomsday on June 30, 2017, 07:54:28 PMgood consolidation for tibias but yeah quite unusual for the nail to stick out. I guess it makes no difference  as long as you dont hit that sticking out part. Did you get any recent xray to see progressing consolidation ?

edit

The doc knew his stuff. You had the hexapod frame , the same used by Dr daghoon Lee.

Yeah sure I'll try to post them because now I only have them in film and not digital. I'll try to get a digital copy of Incan

Yup it's true that he wasn't a cosmetic limb lengthening doctor, but he sure wasn't some quack either

Edit Post

Hey guys just a short progress report. I realise I am now able to do squats for about like 10 times straight before feeling tired. Also I have regained that torque needs to initiate jogging but my muscle strength has yet to allow me to run or jog normally

Cheers!

Edit Post

Message from a member:

"hey there sibirsky
how are you doing with your progress?"
-I'm doing fine  thanks!

"Im looking for some words of advice,...
from reading here and there on this forum, i gather that the more popular or reasonable way to lenghten (if youre into getting it done in 1 surgery), is to do Femur lengthening.
I know you chose to do tibia.

thus I have few questions in mind -
1- This may be totally misperception of mine, but i feel like femur lenghtening is actually more complicated, its a bone deeper within tissues of the leg. and biomechanically speaking, it feels to me as if a change of this portion of the leg (femur) makes much more of a mess to the funcion of walking, running etc. again, im no orthopedic surgeon nor that anatomy expert, but thats my impression.
-why did u choose to do tibia?"

-2 reasons: It's (WAY!)cheaper(or way less painful in the case of external femurs) and using externals allow correction. Choosing internal femurs may not allow to have precise correction because we'd need a hexapod for that. However I do understand that for the knee joints is better to do femurs if you need hugher lengthening  though I can't be absolutely sure about this. What i am absolutely sure about is that the ideal tibia:femur ratio is 0.8 and so for the best results one should measure ones legs via x-rays and only then see which limb would be the best to be lengthen so that there is the least deviation from this ratio. The tibias should best not exceed the size of the femurs post lengthening

"2- I just happen to see on Youtube a video of a kid underwent tibia lenghtening by dr. mahboubian, and his walking post op (few months) seems totally normal. to be honest that made me thrilled and totally made me rethink about tibia as an option..."

-Not to burst your bubble or anything but children's bones are very different from adults. Less weight bearing is needed and the bones are thinner and more malleable. Hence the time needed to wear ex-fix is much lesser. However it's not recommended kids use IM nail because it could injure  growth plates so there's that..

3- "whats your take about surgeons who dont do this ll as cosmetic surgery routinely?
and about the 'less advanced' techniqes regarding this operation and its advantages / disadvantages...."

-So firstly we must first understand what counts as a limb deformity? It could be angulation (bow legs/knock knees) it could be translation issues, but most importantly in our case, a deformity can be a limb length discreapancy where one leg is longer than the other. So by default surgeons who specialise in this field are adequately trained on how to lengthen limbs and equalise them. The should be well-trained in carrying out osteotomies . But what differs in cosmetic cases is the amount that a patient wants to lengthened (which is not fixed unlike deformity cases where the lengths need equalising) and the ethical dilemma of it: is it morally correct to break a perfectly healthy persons legs in order to solely bring about a cosmetic benefit, perfectly knowing athletically the patient may not reach pre-surgery levels of fitness?

So in essence I think that an orthopaedic surgeon that is qualified in the aforementioned types of deformity correction procedures can commit to the patient and accept the consequences from a moral standpoint, it should be fine

As for technology...I can't really comment too much. From what I understand generally, more advanced=more expensive=more comfort + faster recovery


"Hope for your speedy recovery"
-Thanks man! All the best to you too

Edit Post

Hey, I was just wondering how long did it take you to walk on crutches after nailing? I heard it hurts a lot that you technically can be using them but they might cause damage until a certain time has passed. What was your experience with nailing like?

Edit Post

Quote from: Mikayyy on July 11, 2017, 02:17:29 AMHey, I was just wondering how long did it take you to walk on crutches after nailing? I heard it hurts a lot that you technically can be using them but they might cause damage until a certain time has passed. What was your experience with nailing like?

1 month after nailing I started using a walker. About a week later I was strong enough for crutches and like about less than 3 weeks later  I was already walking without support. So yeah I progressed quickly.

Nailing is fine in my case so far. I mean it's been really well I honestly have no idea why anyone would prefer externals other than cost factors. But that's just my case; there might be some bad experiences with LATN so I can't guarantee a great outcome