Is my tibia misaligned?

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Quote from: marathonrunner on October 21, 2019, 04:18:53 AM

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).

Also the nail is worrisome, it may be not inserted enough, bothering knees

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Quote from: TemakiSushi on October 22, 2019, 11:25:20 PMAlso the nail is worrisome, it may be not inserted enough, bothering knees

I do agree with TemakiShushi in that the nail may be not inserted deep enough as compared to the right leg, which may cause knee pain as well as difficulty standing and walking.  You may also ask another doctor about this concern.  Personally I think misalignment in your left leg is not too bad, although it could be better to have a good alignment.

Fibula needs to be fixed from the beginning.  I know a patient who did tibias with Precice with Dr. Paley, several years ago.  Back then, doctors were not really aware of importance of fixing fibulas, so even Dr. Paley didn't fix it.  Later that patient found a problem in fibula, like fibulas were not extended as much as tibias so they were already preconsolidated, preventing further distraction and other problems.  So Dr. Paley broke his fibulas again and inserted screws to fix them with tibias.  Then the patient finally finished his journey.  Ask your doctor whether he can do it or whether it is necessary at this moment.

I also think your legs, especially left leg, are very tight even though you lengthened barely 4 cm.  There are many indications about this.  The screw in the left ankle is bent severely.  Your left leg seems to have some degree of  ballerina foot.  You have pain in left shin.  This pain in shin is very common nerve for tibia patients who lengthened quite bit or whose legs are too tight.  Basically your muscles are pulling your nerve.  But it will go away as you stop or slow down, which depends on how your leg can recover.  Stretching is good.  However, in your case, it may be too hard for you to do aggressive PT.  Sit up on the bed and use a towel or a stretch strip to hold your toes and pull your ankle as much as you can.  Hold it for at least 30s and repeat at least 3 times.  Another good PT for you is to raise your leg as much as you can using a towel or a stretch strip.  Lie on bad and hook up your foot with a towel and pull it up.  Legs should be straight, which is important to straighten your knee.  Do these PTs many times a day.

Hope you feel better.

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yes thanks, for all these issues I will go over everything with the 2nd doctor and make sure it’s all cleared.

If I’m going to have these nails in my leg for 1-2 years and I live a really active lifestyle I’m going to need to fix whatever needs to be fixed.

I had a feeling it was nerve pain in the left shin, because of the infection I had, I had to remove more skin at the infection site (osteotomy site) which made everything in the front left leg tighter than the right.

So not just muscles being tighter the skin is tighter as well.

I will write a list of “tibia lengthening dos and don’t” after I finish this journey I think people considering tibia LL can learn from all the stuff I’ve been through.

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Quote from: TemakiSushi on October 22, 2019, 10:59:15 PMIt doesn’t matter if it’s with IM nails or not
Fibula should not be much shorter then tibia if it got union

Can someone who understands TemakiSushi's point please explain this other words? He is saying fibula should not be much shorter but how is this possible in an external only scenario? For example here are kilokahn's xrays can be found here http://www.limblengtheningforum.com/index.php?topic=634.msg19014#msg19014 and here http://www.limblengtheningforum.com/index.php?topic=634.msg15499#msg15499

I really appreciate and hope to understand this better.

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Guys how to post pics with thumbnails as seen here?

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Cena: sorry I have no clue :[

Nomad: look at the very first pinned thread in the patient experiences section, there are some good instructions there

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Here also have similar problem
After surgery in both tibias

Finally leg left in angle 4°
Right leg 2°

Doctor said normal parameters but unfotunately left leg is not good, disturb, unconfort and little pain
Im worried maybe need new surgery for correct this bone angle
😩

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Quote from: Mon on November 27, 2019, 03:48:42 AMHere also have similar problem
After surgery in both tibias

Finally leg left in angle 4°
Right leg 2°

Doctor said normal parameters but unfotunately left leg is not good, disturb, unconfort and little pain
Im worried maybe need new surgery for correct this bone angle
😩

Yes you probably need extra surgery to fix the misalignment otherwise this condition will lead to various joint problems

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This days so worried and think to much in that second surgery needed it

But then no understand why doc said its ok. Do u have normal parameters in both tibias angle???

Maybe some special exercise?
Help me!

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Exercise does not help misalignment at all
Most CLL doctors are crappy
Don’t trust 100% of what they tell you
Tibia surgery is lot more complicated than femurs
Many get misalignment without realizing it and long after surgery they notice something is wrong
Where are you now?
I’ve done quite a bit of research about tibia surgeries, I can tell only doctor I can trust for tibia lengthening is Donghoon
He can fix misalignment very precisely