I promised so here I go
1) He lengthens between 5-9 (sometimes 10) cm on tibias (though he sais that in terms of proportions 9 is really pushing it and 8 is the max)
2) He uses the precise nail alongside the external fixator (He STRONGLY PREFERS the external fixators).
3) No LON or LATN (Says can cause misallignemnt problems which are much more difficult to deal with unlike pure externals)
4) Achilles tendon lengthening is not the big black boogieman that this forum (and the other one) s saying it is (It usually starts between 4-6cm and he prefers to do it immidiatly as it starts because prognosis is much better than to wait it through physiotherapy)
5) Best physiotherapy according to him is Walking Walking walking. You walk almost immidiatly after operation
6) time frame is usually the same in terms of healing (9-12 months)
7) He no longer operates in Lecco (he has his clinic there though). He works in the San Camilo hospital.
These are the important points I remember from the consultation if you have any more questions feel free to ask
Quote from: Ozymandias on February 29, 2016, 09:28:26 PMI found quite disturbing that most of those statements are completely different from what most LL doctors advise.
Who are these doctors? Paley that was his student for 6 months? Guichet (which also is the only LL doctor that encourages to build muscles before LL)?
He says that physio doesnt really help prevent equinous of the foot.. Only way to keep streching the tendons is to walk.
Sorry for the bit aggressive response... It's the Israeli in me.
To be more precise, I also was in a bit of shock when he told me about physio. I said to him that on the forum about the subject other doctors are taking physio really seriously. He said that according to his own experience, walking was the best physio (and this is why he encourages it as soon as possible). He said that he gives you exercises to do at home and stuff but that walking (and also swimming) are the best two things to do.
I asked about lengthening more than 5-6. He said that the blood vessels regenerate (And he is correct) and that one knows his limit when nerve pains start. The most limiting factor is the muscles and the achilles tendon (which cause bent knee and ballerina respectivly). I asked him about athletic recovery. He said that from his follow-ups, those that went skiing returned to skiing, those that went swimming returned to swimming and those that were running returned to run.
He advocates for atleast 5-6cm (he usually dont accept people who wanna do less) because he sais that it's not worth it (the process and psychological burden).
What I really liked about him that a few people in the town (lecco) said that even though as a person he can be pretty bad, as a doctor he is number one (when we asked people where Catagni's studio is and then we asked them about him). I also liked the fact that he doesn't push you to do it. He said to me "If my son was unhappy with his height I wouldnt suggest him to do that.. But if he would have persisted, I would be the only one I would let my son do it because I think I am capable". Also, he didnt tell me to start thinking about when doing it now.. He told me to talk to the 15-20 patients and ex patients on a list he gave me (with emails and phone numbers) and than to think if this is what I really want. If I would want to do it, that I should know all the risks, and especially the heavy psychological burden of being in these frames for so long.
Quote from: hyong on February 29, 2016, 11:16:59 PMIs it possible to differentiate between nerve pain and muscle pain? , i know i sounded kind of silly asking this but just curious about it
Nerve pain is usually a chronic pain that does not correlate with movement. It is a pulsing pain. It can also come along with weakness of the limb or loss of sensation. Muscle pains, if you touch where it hurts you, it will hurt more. It will become greater with movements and is usually very acute during the making of certain movements.
1) about the misallignment. To make myself more clear, it's not that it would not happen with pure externals, but what I meant is that if it happens with externals, it is much much much more easier to correct (you do it by simply manipulating the device). He said that the tibia with internals is not good also because of the shape on the bone (having a narrow middle part and pretty large distal parts) which make the nail unstable thus augmenting the possibility of misalligment.
2) ATL. I talked with him alot about it. He said that it's better to do it immidiatly when ballerina appears and not afterwards (which will make the recovery much much worse). I said about loss of force or function because of it. He said "Cazzate" which means bull . He does it all the time (with cosmetic and non) and there doesnt seem to be any problem with doing it (if it's done properly... Crimsonetide's scar clearly shows that Dr.Shah has no idea what he is doing with a knife). He showed me photos of scars of this ATL and they dont look like anything that Crimsontide has.
3) About lengthening amount.
Because he knows that people who do it are not really short and that the problem is in their heads, he prefers them to do larger amounts because they will rarely be satisfied with anything below 5cm (he said that it was at this mark +/- that people started to become satisfied of their new height). I said to him that other docs prefer to put 5 at max. He replied that it's because they are not good enough.
Anyway, this meeting with him really helped with my height neurosis. I am much more calm about this whole thing (Before it seems I was ery very scared from this operation). Now, after facing an LL doctor and really talking about everything my mind is in peace. If will do this thing it will be with this guy. Now I will just need to know if I will eventually do it.
So this is me leaving this forum for now. Good luck to everyone
Physiotherapy. It doesnt help. Everyone get's ballerina. It can help reduce it and even solve it only after you got it.
complications: He didnt say they wouldnt happen, but that he knows how to handle them.
ATL: Where is the research about it's devestating effects?
Quote from: Slim_tim on March 17, 2016, 03:46:00 PMprice for tibia?
20k
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