Jexus, Tibial LON with Monorails - Dr. Muharrem Inan @ Turkey

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I walk the same, would be lovely to know how long it's going to take until rather normal gait

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Quote from: InferiorityComplex on December 17, 2017, 09:50:59 AMI walk the same, would be lovely to know how long it's going to take until rather normal gait

My friend who did 7cm on his tibias at dr Inan also walks the same. I think it won't take too much if we work out those muscles.

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These are my legs before the surgery:

http://hpics.li/fd7a7e6


These are my new X-rays.

I measure it same again a 0.6 - 0.8 discrepancy. But I feel absolutely no discrepancy when I walk and the doctor in Muharrem Inan's crew says it is impossible for me to have a discrepancy. By the way, as you can see in the picture above my left leg used to be 0,55mm longer then the right one and if the following X-rays show it true now my right one is lengthened 0,7 mm more and now they are almost equal.

http://hpics.li/a7c893e

http://hpics.li/2fa6196

http://hpics.li/94214c7

I wonder how much I gained from this surgery. Is it more than 6cm considering the before and after photos?

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You had bow legs before surgery. And taking in mind that you used monorails that can't fix bonus deformities, you still are having bow legs which also makes the added height not exactly the same as the lengthened bone due to tibia not being vertical comoletely to the ground.
Imo you should have used Ilizarov to get taller and fix your bones at the same time (and gain more actual height by doing that).

So your bones are lengthened more than 6cm but the actual height you gained should be about 0.5-0.8 cm less due to your bowed legs.

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Quote from: Body Builder on December 18, 2017, 10:56:07 PMYou had bow legs before surgery. And taking in mind that you used monorails that can't fix bonus deformities, you still are having bow legs which also makes the added height not exactly the same as the lengthened bone due to tibia not being vertical comoletely to the ground.
Imo you should have used Ilizarov to get taller and fix your bones at the same time (and gain more actual height by doing that).

So your bones are lengthened more than 6cm but the actual height you gained should be about 0.5-0.8 cm less due to your bowed legs.

Definitely. My legs were very bowed before the surgery.

Dr. Inan said he fixed my bowed legs too and said: "You won't be walking like a football player now on".

I don't know how he did that but they look really straight now.



In my calculation considering that Left was +0,55cm compared to the right.

I'll take left 6,15cm lengthened and right 6,88cm lengthened.

Now my right leg is 0,18cm longer and my I gained 6,33cm (6,88 - 0,55) if we say I don't have bowed legs.

I'll post a picture of my legs too.

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Hi Jexus

Im a little unsure of the difference between LON and LON with monorail?

1) Did you ever discuss the risk of intramedullary infection with Dr Inan and do you know if he seen it before in any of his patients? Does monorail LON carry the same risks as non monorail LON?

According to below data, the odds of infection can be high but seems some patient specific contributing factors may vary. My main concern would be if it occurs, how often are they unable to treat it resulting in serious consequences like amputation?

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3377147/

"However, the risk of creating a deep intramedullary infection with LON is a universal concern. Infection rates of up to 22% have been reported,6,8,10 so much so that some authors have discontinued this technique and have returned to conventional Ilizarov method.8 Though many published articles show high infection rates, Chaudhary in his 279 and Kocaoglu et al.11 in their 42 LON procedures reported 0% and very low infection rates, respectively. Simpson et al. in their series of LON had three infections, all occurring in patients with limb shortening secondary to open fractures.6 Hence, appropriate patient selection may prevent this complication. Chaudhary concluded that the risk of infection in LON is real, but if meticulous technique of wire placement and other precautions to prevent infection are observed, the rate of this complication in LON can be brought down".

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Quote from: 3inchhope on December 18, 2017, 11:56:38 PMHi Jexus

Im a little unsure of the difference between LON and LON with monorail?

1) Did you ever discuss the risk of intramedullary infection with Dr Inan and do you know if he seen it before in any of his patients? Does monorail LON carry the same risks as non monorail LON?

According to below data, the odds of infection can be high but seems some patient specific contributing factors may vary. My main concern would be if it occurs, how often are they unable to treat it resulting in serious consequences like amputation?

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3377147/

"However, the risk of creating a deep intramedullary infection with LON is a universal concern. Infection rates of up to 22% have been reported,6,8,10 so much so that some authors have discontinued this technique and have returned to conventional Ilizarov method.8 Though many published articles show high infection rates, Chaudhary in his 279 and Kocaoglu et al.11 in their 42 LON procedures reported 0% and very low infection rates, respectively. Simpson et al. in their series of LON had three infections, all occurring in patients with limb shortening secondary to open fractures.6 Hence, appropriate patient selection may prevent this complication. Chaudhary concluded that the risk of infection in LON is real, but if meticulous technique of wire placement and other precautions to prevent infection are observed, the rate of this complication in LON can be brought down".

Did you ever discuss the risk of intramedullary infection with Dr Inan and do you know if he seen it before in any of his patients?

I didn't discuss specifically "the risk of intramedullary infection" with Dr. Inan but we had a general talk about the risk before the

surgery. He said there haven't occurred any complications that they couldn't have fixed yet. Considering that he uses monorail LON

on almost every tibia lengthening patient and also femur patients who don't want internals he is cool with that.


Does monorail LON carry the same risks as non-monorail LON?

I didn't specifically ask this either but he always prefers LON to pure externals. Probably the risk of the pin site injections changes

but I don't have any knowledge regarding that.

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Thanks Jexus

The issues you have with your hip dropping, had Dr Inan mentioned if he has seen this before? Are you seeing much improvement in dealing with this?

Do you know if the risks of hip drop issues is greater with LON monorail?

Also do you have much knee pain ?

 Also can you say how long would someone need the assistance of a nurse?

Im not from Turkey so trying to get an understanding of how time and expense to rent accommodation and to hire a nurse for day to day tasks.

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Quote from: 3inchhope on December 19, 2017, 08:26:18 AMThanks Jexus

The issues you have with your hip dropping, had Dr Inan mentioned if he has seen this before? Are you seeing much improvement in dealing with this?

Do you know if the risks of hip drop issues is greater with LON monorail?

Also do you have much knee pain ?

 Also can you say how long would someone need the assistance of a nurse?

Im not from Turkey so trying to get an understanding of how time and expense to rent accommodation and to hire a nurse for day to day tasks.

The issues you have with your hip dropping, had Dr Inan mentioned if he has seen this before? Are you seeing much improvement in dealing with this?

I think this is a really minor issue. I didn't talk about this yet but I'm sure he will say that this is completely normal. Yes I definitely see improvement even though I don't do any exercises (I should). I just walk around the house and I think it gets better just by walking.

Do you know if the risks of hip drop issues is greater with LON monorail?
In my opinion, considering the videos of LL patients that I watched everyone walks a bit weird in the beginning for example there were videos of Dr. Lee's patients on youtube you can watch them. I will ask this anyways in 2 weeks when I go to check-up at the clinic.

Also do you have much knee pain ?
I've had absolutely no knee pain until now.

Also can you say how long would someone need the assistance of a nurse?
It changes a lot because for example till 3cm I was walking really easy and then it started to hurt and I couldn't walk. After 5cm it was a real torture for me until the frame removal I had huge ballerina and also my legs were so sensible and hurting. Actually you can handle it %90 of the times alone but especially when you have to do hard things like to travel a long distance or when you to go downstairs it is better to have someone to assist you. Also I know LL patients who fell down and had hard times when they were alone.

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Hey, Jexus, can I ask what was it that made you decide to go ahead with the surgery? What made you think using lifts/elevated shoes just wasn't enough? I truly understand it is a completely personal decision, but I wanted to hear your thoughts on it, if you feel like sharing them. We're basically the same, both in terms of pre-surgery and desired post-LL height.

I've been seriously pondering about whether I really should be putting my savings towards LL. Can't I be happy with just lifts? I never wanted to be too tall, anyway.