St. Petersburg Lengthening -- DISTRACTION COMPLETED

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Thank you so much for all this valuable information!

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Hey California2 how are you feeling? how is consolidation going so far?

Hope all is good!

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I am having an unrelated procedure on my foot.  My podiatrist wanted to be certain my Achilles tendon is fully stretched. 

He recommended a device made by Joint Active Systems:  https://www.jointactivesystems.com/products/jas-sps-ankle.

It is a boot you use to for both plantar flexion and dorsiflexion. 

I am generally not a fan of devices but this works pretty well so I thought I would bring it to the list's attention because of its potential application in tibial lengthening.

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Seems very useful to use during distraction and consolidation stages for patients who are doing internals. Don’t think this would work with patients that are doing externals but until after the frames are removed. Thank you for the information! How is everything going, btw? How are your legs feeling?

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I do not generally reply to PMs because doing so prevents others from getting the same information and causes repeat questions.

One poster asks:

After reading your diary I staring seeing Dr. Solomin & Dr. Kulesh as my potential go-to for Cll. Are they still taking cosmetic cases and is there a height restriction? I’m a 23 y/o male with a height of 1.77-1.78.

My impression is that Russian surgeons give you their best advice for your situation; whether or not you follow their advice is more up to you than in the USA.  I am not aware of any pre-surgery height prohibition.

Also, I read that in total you spent $22k on everything, $15k on surgery related expenses and $7k on everything else. Do you think this price could be lower if I did somethings differently, i.e instead of staying in the hospital for 3 weeks, leaving after 5-7 days, not hiring a maid/cook, etc... things like that.

No. I doubt you could reduce the overall price by much--it is already quite reasonable.

Best of luck.

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Thanks for your excellent and detailed reports, California2.

I was wondering about what you said a few posts up, that people sometimes leave the nail in forever. Is this the case for both the LON nail and the thicker LATN nail?

I am somewhat bow-legged and average height (1.79m) and am considering having LL while simultaneously having my tibias straightened, which will hopefully prevent me needing knee replacement in the future. I would be happy with 4 cm. Do you know of any patients who have done that with Drs Solomin and Kulesh? I understand it would be LATN, with the straightening done alongside the lengthening. Would it require extra time to do the straightening?

On a long term note, I enjoy lifting at the gym - reasonably heavy: squats up to 100kg. Would that be possible a year or so after the surgery? Ever? Would I need to have the nail removed?

Many thanks once again for your kindness in taking the time to post.

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I encourage you to direct specific questions to your surgeon but I am happy to share my understanding of things.

As for bowed legs--purely external can correct bowed legs because the bone can continue to be aligned after lengthening but before consolidation.  Once a nail is inserted, the bone is fixed in position.  Consequently, if you decide on a procedure that uses any form of nail or rod from the start; then, you cannot correct bowed legs.

Professor Solomin and Dr. Kulesh regularly fix bowed legs but it usually means more time in frames.  You should speak with them about options. 

As for LON or LATN-- the nail inserted is simply an inert metal rod--no magnets or anything to worry about.  The nail is completely encased in bone after healing.

(On a related matter, because my nails are Russian, when I had an MRI through the VA I was concerned that my nails might have been made from old Lada parts and that my legs would be slapped against the MRI wall.  The technician tested my nails with a huge magnet and assured me my nails were inert medical grade devices.  Moreover, the nails I have are actually made in Poland.)

To remove the nail, you must open the bone to get to the nail.  Many people remove the nail--I am not sure why--is it because they do not like a foreign object inside their bones or because they believe bone is more flexible than metal--who knows?

My US surgeon who removed my LATN screws but not my nail was a regular orthopedic surgeon.  He says he repairs broken legs in football players and always recommends leaving in the nail because it just replaces fat stored inside the bone and the bone is far stronger with the nail inside.

So, different thoughts about the same topic.  You should do what you believe to be the correct thing for you when the time comes to make a decision.  If you choose to leave the nail in; it should in no way prevent you from doing anything and may even leave your legs stronger (if you accept my surgeon's position).

Good luck to you.

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Thanks again for the reply.

I saw that you also have bow legs, but you decided not to get them realigned during your external tibias for time reasons. Did the Drs explain how much longer it would take to do so? Is it necessary to complete the lengthening, then start another period of realignment before inserting the nail?

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Whats your level of physical recovery? can you post multimedia material to show it with sufficient redaction personal information to your satisfaction?

congrats on pursuing your dream at a relatively higher age.

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Quote from: chipsnsalsa on January 27, 2021, 11:30:05 PMThanks for your excellent and detailed reports, California2.

I was wondering about what you said a few posts up, that people sometimes leave the nail in forever. Is this the case for both the LON nail and the thicker LATN nail?

I am somewhat bow-legged and average height (1.79m) and am considering having LL while simultaneously having my tibias straightened, which will hopefully prevent me needing knee replacement in the future. I would be happy with 4 cm. Do you know of any patients who have done that with Drs Solomin and Kulesh? I understand it would be LATN, with the straightening done alongside the lengthening. Would it require extra time to do the straightening?

On a long term note, I enjoy lifting at the gym - reasonably heavy: squats up to 100kg. Would that be possible a year or so after the surgery? Ever? Would I need to have the nail removed?

Many thanks once again for your kindness in taking the time to post.


Honestly bro at 179 I would not ever even consider this, but bow legs are free to fix with insurance or the copay will be cheaper than Russia