Quadrilaterals (tibia and femur) lengthening x-legs? non-fitbone patients.

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Hi,

I was wondering for those patients who did quadrilaterals with non-fitbone (ie. no reverse planning) how you guys managed valgus x-legs? I read in IamReady's diary that Dr. Paley first operated on his tibia, then his femurs. As far as I understand, BOTH tibia and femur causes x-legs and with internals it's not possible to correct it. I am more curious about if you already have perfectly aligned legs and you do femurs, how you can prevent x-legs (or is the 1mm/1cm of medial deviation not that much to cause significant x-legs when doing lets say 5-6cm)?

Again, thanks and cheers!

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Very good question. I'd like to hear the opinions of the ones especially who did internal femurs as I want to do too and my biggest concern is x legs.
Also, does fitbone correct malunions? If yes then it is the most superior internal nail but I can't understand how it does it since it just lengthens straightely. Does it has any other function?

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there should be xleg correction surgery

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Fitbone doesn't prevent misalignment in bad hands. There are patients with straight limbs who got misaligned limbs after surgery

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Quote from: jerkey on July 18, 2017, 03:24:40 AMHi,

I was wondering for those patients who did quadrilaterals with non-fitbone (ie. no reverse planning) how you guys managed valgus x-legs? I read in IamReady's diary that Dr. Paley first operated on his tibia, then his femurs. As far as I understand, BOTH tibia and femur causes x-legs and with internals it's not possible to correct it. I am more curious about if you already have perfectly aligned legs and you do femurs, how you can prevent x-legs (or is the 1mm/1cm of medial deviation not that much to cause significant x-legs when doing lets say 5-6cm)?

Again, thanks and cheers!

This is an interesting topic for me. I understand why femur causes x-legs but in the case of tibia in which the anatomical and mechanical axis are the same, why would internal lengthening cause valgus? I had a 3° valgus before lengthening and afterwards, I can't say I notice any difference. I'm waiting until 6 months or more to do a full scan and understand the changes in my biomechanics as well as any possible valgus which can predispose to osteoarthritis. However, I can't seem to find how much of a valgus entails a risk of osteoarthritis and the degree of valgus (whether severe or moderate)

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Tibia LL if done correctly won't cause varus or valgus.
That's why we talk about femur LL or quadrilateral lengthening.

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Cases of femur and quad definitely cause X-legs no matter what nail. Fitbone doesn't prevent anything when it's badly used.

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Quote from: realpatient on July 18, 2017, 08:05:36 PMCases of femur and quad definitely cause X-legs no matter what nail. Fitbone doesn't prevent anything when it's badly used.

We don't talk about bad use bad generally.
The other nails on femurs cause some degree of x legs no matter what. Has the fitbone any different function to lengthen and correct the bone at the same time?

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That's bull

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Quote from: realpatient on July 18, 2017, 09:22:41 PMThat's bullcrap

And you must be idiot.