Quote from: maximize on April 12, 2015, 02:43:29 PMBluebarbie, I find the misalignment of your femurs as well as the explanation your doctors have given you for how they plan to correct it (during nailing) somewhat disturbing.
The exact, precise, proper alignment of your femurs is very important to your hip, knee, and ankle health long term. Currently your alignment on the monorail is way out of wack. Dr. Singh has told you he will "fix this during nailing". But I cannot see how this is a good approach.
Your bones will start consolidating soon. Once they do, your ability to fix the deviation will decline. Furthermore, "roughly approximating" the realignment by manually shifting the knee during nailing is not likely to be precise enough to give you the correct alignment you need.
It's possible I am wrong on this, but we have seen many, many people get butchered by misalignments like this and never become able to walk properly again. If I was you, I would be safer than sorry.
The safest and most accurate way to correct your misalignment before consolidation occurs is probably going to be to have the monorail immediately removed and a external Ilizarov with Hexapod or Taylor frame attached. These devices will allow computer planned accurate realignment of the femurs within only a few days of wearing. Once the realignment is done, you can still get nailed into position, and continue with recovery as planned. The point is, with the Hexapod realignment, at least then you will be getting nailed into a correct alignment.
There are many doctors who offer this procedure. You could talk to KiloKahn about the doctor he's being treated by in India who is not too far away for you (Dr. Parihar). He seems affordable, has done a very good job with Kilo so far, and treats deformities via Hexapod regularly. Perhaps you can e-mail the doctor your current xrays and see what he thinks.
I would very strongly caution you about taking a "wait and see" approach. If that consolidation occurs, and you are not in a good alignment when it happens, you may never walk normally again or you will require multiple much more difficult surgeries to be able to. I think it would be much more affordable and beneficial for you to pay for the Hexapod realignment now than try to fix this once your legs are consolidating in a potentially crooked position.
For illustration purposes, this is what I'm trying to help you avoid:
It would probably not cost more than 10-20K to travel to India, get the Hexapod realignment, and go back home. For the money your parents have already paid, this would I'm sure be worth it to them to avoid having their daughter potentially crippled like the guy above was. 4 years of surgery later and he still can't function properly.
The only thing I'm not sure of is if it is safe to remove the monorails and attach Ilizarov while you have such extensive callus between the bone fragments. You wouldn't want to disrupt that callus and then end up with nonunion either. I would send the xrays to that Indian surgeon as well as perhaps the experts out there like Dr. Paley who can advise you further on the safest next course of action.
Hi, maximize
Thanks alot for all ur concern for me. About that misalignment thing, Yes! As soon as I saw my very first xrays, left femur, 7days post op, I couldn't help myself from crying and begging my doctor to realign it again for me. But he insisted and promised that it will go straight again and I won't have a problem after the internal nailing is done. There were many other doctors, nurses and my family members there when that battle happened. So finally I just gave in and restrained myself from ever thinking about that again and become depressed over it. But during the distraction phase, I find the right femur slowly getting misaligned, too.
As for me now I don't really think about it or worry that much anymore coz like u mentioned it can be fixed somehow. What is really disturbing me currently is that, with LATN method, it's likely that we lose our cms during that internal nailing surgery. And for me with that misalignment thing, I don't even know what to say....
I had emailed other doctors like u suggested me, Dr Rozbruch and dr Aporn from Thailand. Well I thought about Dr Paley and Dr Guichet too, but they mainly practice in internals so I didn't contact them.
Yes for me, I would do anything or travel anywhere as long as I gain my targeted length at least 7 cms. External femurs is like a living hell and there is no way I will let those hard earned cms go away.
Alex,
I wanted to do with internals but as my bones are too small and risky to go with that method I had no choice but go with this hybrid method.
Firstly my knee bending is very bad and the longer I stay in frames, the more likely it is to get stiff knees for a longer period of time and recovery. And I worry very much about subsidence with pure externals. Even with this nailing thing, I am really stressed about losing my gained length during that surgery. But with this u can find out immediately and once it's done, the nail locked,it's over and no more compressing over time. Plus I have this misalignment thing that need to be fixed.
