Is my tibia misaligned?

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which country did you do the surgery from?

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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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The standard way is to lengthen 1mm after surgery to test the nail and then start lengthening from day 7. That is how they do it at Paley's. Guichet does 1cm lengthening after surgery and even Betz (?)

I am surprised you have not had this discussion with your doctor marathonrunner.

Was your infection an incision site skin infection? Does it go back inside the bone like that? I didn't know this was possible.

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It look little bit misaligned (Negligible) It will be fine once the callus start forming .

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I would be lying if I said that looked aligned... I'm not sure how responsive your doctor is but mine showed me X-rays of old patients saying mine would be fine. I was extremely worried about pre-consolidation so I was shown other xrays that were similar to mine and that ended up fine.

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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.

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Quote from: Beforeandafter on October 21, 2019, 12:59:43 PMIt look little bit misaligned (Negligible) It will be fine once the callus start forming .

It is not negligible at all
How you could be soooo irresponsible

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May i ask who is your Dr?

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I would rather not say publicly, feel free to message me, I’ve already stated I did the procedure in Singapore.