Tibia Lengthening (Precice 2.2) with Dr Assayag

Edit Post

Day 26 – Reached the Half Inch Mark, Average Heights in the U.S., +1.275cm (0.50 inch)

https://heightjourney.wordpress.com/2022/08/09/day-26-reached-the-half-inch-mark-average-heights-in-the-u-s-1-275cm-0-50-inch/

Edit Post

Quote from: HeightJourney2021 on August 10, 2022, 01:54:00 AMDay 26 – Reached the Half Inch Mark, Average Heights in the U.S., +1.275cm (0.50 inch)

https://heightjourney.wordpress.com/2022/08/09/day-26-reached-the-half-inch-mark-average-heights-in-the-u-s-1-275cm-0-50-inch/

Hey HJ,

one quick question..What does Dr Assayag think about non unions ? Do they depend on the type of osteotomy done? Are they treatable 100 % in case of LL as the fracture here is induced ?

Edit Post

Quote from: Realistic on August 10, 2022, 06:41:39 PMHey HJ,

one quick question..What does Dr Assayag think about non unions ? Do they depend on the type of osteotomy done? Are they treatable 100 % in case of LL as the fracture here is induced ?

I asked Dr Assayag about non-unions a while ago. I don't think the type of osteotomy is a significant factor. A qualified limb lengthening doctor should follow these guidelines.

1) Prevention is the best medicine. Analyze X-rays carefully to detect a delayed union which can lead to a non-union. If a delayed union is detected, adjust the lengthening rate as follows.
a) Slow down lengthening rate
b) Temporarily stop lengthening
c) Reverse lengthening, if the device allows it

2) Bone graft. This is the last resort, so make sure you can prevent it in step (1) so you don't have to resort to this.

Edit Post

Day 29 – Bi-Weekly Appointment with X-rays, +1.50cm (0.59 inch)

https://heightjourney.wordpress.com/2022/08/12/day-29-bi-weekly-appointment-with-x-rays-1-50cm-0-59-inch/

Edit Post

Day 31 – Review of Week 4, Physical Therapy, +1.65cm (0.65 inch)

https://heightjourney.wordpress.com/2022/08/14/day-31-review-of-week-4-physical-therapy-1-65cm-0-65-inch/

Edit Post

Day 37 – Review of Week 5, Losing Dorsiflexion Angle, Scars, +2.10cm (0.83 inch)

https://heightjourney.wordpress.com/2022/08/20/day-37-review-of-week-5-losing-dorsiflexion-angle-scars-2-10cm-0-83-inch/

Edit Post

Quote from: HeightJourney2021 on August 11, 2022, 12:11:02 AMI asked Dr Assayag about non-unions a while ago. I don't think the type of osteotomy is a significant factor. A qualified limb lengthening doctor should follow these guidelines.

1) Prevention is the best medicine. Analyze X-rays carefully to detect a delayed union which can lead to a non-union. If a delayed union is detected, adjust the lengthening rate as follows.
a) Slow down lengthening rate
b) Temporarily stop lengthening
c) Reverse lengthening, if the device allows it

2) Bone graft. This is the last resort, so make sure you can prevent it in step (1) so you don't have to resort to this.

Thanks HJ.. I think the osteotomy technique does make a difference though.. It is the reason why Dr. Lee hasn't had even 1 for stature lengthening.. Paley's site mentions about osteotomy technique as well IIRC

Edit Post

Day 39 – Physical Therapy Progress, Videos of my PT Exercises, +2.25cm (0.89 inch)

https://heightjourney.wordpress.com/2022/08/22/day-39-physical-therapy-progress-videos-of-my-pt-exercises-2-25cm-0-89-inch/

Edit Post

Hi HJ

I have a question for you / maybe Dr. Assayaq if you find it good enough and have the chance to ask him:

With Tibia lengthening my impression is that while the tibia bone is hold firm into place the bone next to it (fibula) is not. But the fibula is also bent at an angle while the tibia is more straight. How do they avoid the fibula changing its natural “bent” angle during tibia lengthening when it is not “kept in place” like the tibia is. And maybe it is impossible to do this due to its natural bent angle. Will this not be a problem if one lengthens a lot on tibias? I would guess there is some important bio-mechanical reason for the fibulas to have this natural bent angle, which from before and after X-Rays seems impossible to conserve with lengthening.

Edit Post

Quote from: TheDream on August 23, 2022, 03:19:39 PMHi HJ

I have a question for you / maybe Dr. Assayaq if you find it good enough and have the chance to ask him:

With Tibia lengthening my impression is that while the tibia bone is hold firm into place the bone next to it (fibula) is not. But the fibula is also bent at an angle while the tibia is more straight. How do they avoid the fibula changing its natural “bent” angle during tibia lengthening when it is not “kept in place” like the tibia is. And maybe it is impossible to do this due to its natural bent angle. Will this not be a problem if one lengthens a lot on tibias? I would guess there is some important bio-mechanical reason for the fibulas to have this natural bent angle, which from before and after X-Rays seems impossible to conserve with lengthening.

As long as you have a qualified orthopedic surgeon, it should not be a worry. The natural bent angle of the fibula is very small and as the gap expands, callus formation will replace the gap and then calcify into bone. Also, the large locking screw to secure the end of the fibula to the tibia is very secure and will not be displaced, unless you place recklessly excessive loads or force on your lower leg. If you do go that far, then the internal nail or locking screws will most likely bend or break anyway and you get what you deserve for being so reckless.