Is my tibia misaligned?

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I thought 0-5 degrees was the threshold for alignment.

Mine seems like it is way above 5 degrees, is this ok? Plus.. its been almost 3 months now and I can walk just fine with my right leg but my left leg has been having weird pains in the knee, below the knee, in the lower tibia area and when I walk on my left leg I land on the front half of my feet. I think because of the angle of the bone my left leg naturally lands on the front of the feet instead of in the middle. I dont have this problem at all with my right leg. Is this normal? Did anyone else have any sort of misalignment issues with their leg or legs?

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whoa images too big, here we go

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Hey, yea I asked before but I just did some angle measurements which are new so thought I would ask again with this new info. From my understanding it’s acceptable from 0-5 degrees off, my right leg is only 1-2 degrees off so almost fully straight, my left is off by around 8 degrees so that’s what I’m worried about.

I’m almost done lengthening should be done in the next week or 2. I’m just curious if anyone else had this issue and if they had to do another surgery to correct the deformity. I don’t know how my leg would feel once fully healed but right now my left leg is in much worse shape than my right. Functionally it’s almost impossible to walk on the left leg, my right leg is completely fine. And even exercising or standing up straight I’m having a lot of issues with the left leg, again the right one is fine. I feel like I could be walking quite well if both legs were like the right one.

So just curious if someone with a similar situation needed a secondary surgery or if things were fine after the legs were fully healed.

Which doctor out of the 2 you mentioned would you recommend for a second opinion?

Parihar or Giotikas?

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Another side by side comparison (left side is right leg, right side is left leg)

That left alignment does look pretty scary though right

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Here is a photo of my left leg, you can actually see the misalignment (top bone protruding) from the outside, not just through x rays.

Its a slope down, ---\.....  kinda like this when I look at my leg. So, if anyone else has this issue I would love to hear about it. Or maybe I just had bad luck with choosing my surgeon and I'm the only one with this on my leg :[

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Thanks, I mean if anyone else ever has had this problem I would love to hear what you did to solve it.

My surgeon is not helping at all. He just said, nail is secured in place, and he said all the pains I’m feeling only in my left leg are normal (I feel none of this in my right leg, especially the knee problems, I can’t even straighten out my left leg without immense pain unlike my right leg, when I go swimming my left knee makes clicking sounds like when you crack your knuckle, it will click twice when I go from bent to straight, that can’t be right.. right?). I’ve sent him x ray after x ray and he’s blaming the x ray machines for not taking proper pictures. So.. for someone so avoidance on helping his patient in fear that he created the deformity. I now need to try to find out on my own what the truth is. It sucks when your own surgeon is so in denial they start blaming the x ray machines for not taking proper photos... he said my EOS x ray cannot be trusted. So weird.

Are surgeons usually so dismissive of patient queries or patient problems or is it just my surgeon? 

I have been trying to ask him if I should fix this deformity before bone hardens and I don’t mind switching to an external fixator after I’ve achieved my length. He ignores this and won’t answer my concern. Weird right?

So I only have been with 1 surgeon.. I don’t know how other surgeons are in this regard.

So really anyone that may have had the same problem, I would love to listen to what you did in my situation.

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Oh dear.. you mean I might have get non-union between the bones? I've actually slowed down since around 1 week ago. Instead of doing .66 daily I am now doing only .33 daily. Maybe I will slow down more and do .33 every other day.

For the misalignment, its been like this ever since my first x ray 7-10 days post surgery. The angle has always been protruding like this. My doctor kept saying its normal, its normal but after 3 months, and comparing my left leg to my right leg when I walk, it certainly doesn't feel normal.

Yea.. I noticed the screw in my left leg being bent as well. I was considering taking it out earlier to prevent breakage, my fibula is connecting well so if I take out the screw prematurely it might be ok.

My left leg is tighter than my right but not by a huge amount. I do have some pain in the front shin area (lower tibia bone) on my left leg though. I've never had any external injuries nor did I ever knock my legs on anything (I'm still using a wheelchair and I'm coming up on 3 months). But the pain in the front shin area (left leg) comes when I exercise or stand up to stretch my calves. Since the bones are somewhat misaligned to me it feels like the bottom part of the nail is pushing against the front part of my left leg. I have no other idea as to why I'm getting this pain there as I dont have any external injuries at all, its all internal. So the 3 areas in my left leg that is giving me pain is directly at the knee, below the knee, and lower tibia shin area.

The biggest challenge I'm facing is when I try to walk, my left leg tends to land on the front half near my toes instead of in the middle (or middle back). So it is hard to walk normally even using crutches. When I walk I usually land on the rear of my foot, it makes a rolling motion to the front of my foot and then I switch legs and alternate. But because of how the bone is aligned, my left foot can't really land on the rear of my foot, its hard to make that rolling motion to the front of my foot as well. I don't know how to overcome this with the alignment that I have. So I wonder if other patients out there have had this experience and how they were able to overcome it, especially to walk normally, how do you do it? I just can't get my feet to walk normally even with a walker.

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Singapore

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This was my tibia approx 14 days after surgery (you can see the misalignment already). I can't find my 10 day after surgery photo (but only 4 day difference) but for the comment that said my bone growth in the gap area looks sparse.. is it normal to have around 1cm gap post surgery?

In this photo (14 days) I am above 1cm already in the distraction length. Basically after surgery there was a gap of approx 1cm, not 1mm.

Is that normal? My friend who is doing his surgery with Paley said he started with a 1mm gap, not a 1cm gap. So now I am confused as to why my gap was 1cm post surgery instead of 1mm.

Also ignore that white stuff in the distraction in my x ray here. That is not bone growth. Actually I had an infection at the distraction site on my left leg, if you look at the area to the very right next to my skin (ignore the area between my bones, just look to the right of that next to my skin) you can see the infection forming. I had to get additional surgery to remove this infection, at first doctor said swelling is fine and said no its not an infection but around weeks 3-4 it clearly was an infection and it was quite scary too given how big the bump was. Had to go under the knife again for this.

But anyways, my question now is, is it normal to have a distraction of 1cm post surgery as opposed to 1mm? I started .66 distraction around day 2 post surgery so maybe the bone is getting too far apart too fast?

I have no idea to be honest.. its my first time doing any kind of surgery and it seems I just keep running into issues (or finding out about discrepancies between my distraction and other's distraction).

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Cena: That is weird, I dont know why my doctor didnt do the standard 1mm and instead opted for 1cm. To be honest I just found out about this now after speaking with my friend who is at Paley now. I didn't even know that 1cm wasn't standard.. until now.. I honestly dont know why my doctor didn't do it the 1mm way. It seems like alignment would have been much better if he had done a 1mm gap instead of leaving a 1cm gap. So.. yea I dont know. Scratching my head as well. I wonder if I am going to run into non-union issues now..

The infection was an incision site skin infection, it was the incision site where the bone is broken to create that gap. I think the white stuff in the photo is a combination of the skin infection and something else (bone debris from the surgery? hell if I know :[ ) but you can see the infection clearer in follow up x rays. (Looking at the skin not in the gap)

Beforeandafter: thanks I don't know why but I've been having issues with the knee, with sharp pains in my lower tibia, I honestly dont know what is going on with my left leg because an x ray can't see as well as an MRI, and no way I can do an MRI with metal in my leg. The only thing that is different between my left and right leg is the procurvatum so that is my best guess as to what is causing this.

Cheekycabs: so did you also have procurvatum? how did your leg turn out, was it ok? would be really useful if you've gone through this and can share your experience

I actually got private messaged by another member who had the same issue as I did but their degree was slightly more than mine. He/she told me 3 different ways to fix it, I hope he/she doesn't mind if I share that info here.

(1)   Remove the nail and fix the deformation with TSF.( Opinion of doctors who mainly treat fractures)
(2)   Remove the nail, correct the deformation by surgery, insert the new nail and fix the bones.
(3)   Wait for the bone consolidation, then remove the nail, perform osteotomy, insert the new nail and fix the bones.

He/ or she, I'm not sure as I just have a username, they told me they used the 3rd method to fix their procurvatum because the 2nd method may affect bone length as the bone is still soft.

I don't know all the details but seems they were able to fix this exact issue by doing method 3 which is promising but also kind of sad. I spent a   ton of money on the surgery already for stryde and now need to spend more money and go through more osteotomy and surgery to fix something that should have been done right the first time.

If only I had 2 right legs.. I could be out and about, my right leg feels really good and hasnt had any issues. Its my left leg that is confining me to the wheelchair still.