Tibia Lengthening (Precice 2.2) with Dr Assayag

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Quote from: HeightJourney2021 on August 23, 2022, 11:41:34 PMAs 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.

Hey Hj thanks for your response.

QuoteThe 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.
But surely the angle of the fibula will change as a result of the lengthening right? As the lengthening is along the tibia axis which is straight, the new callus forming along the fibula will follow the tibia angle, and therefore the fibula will change as a result?

Maybe if they break the fibula at the right point this risk is minimized and the probability of non-union minimized or something along that logic.

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Quote from: TheDream on August 24, 2022, 03:09:29 PMHey Hj thanks for your response.

But surely the angle of the fibula will change as a result of the lengthening right? As the lengthening is along the tibia axis which is straight, the new callus forming along the fibula will follow the tibia angle, and therefore the fibula will change as a result?

Maybe if they break the fibula at the right point this risk is minimized and the probability of non-union minimized or something along that logic.


i propose we stop saying HJ - that sounds like a hand job


so basically with the fibula - it can go in many different ways due to the fixation - some docs like assayag screw the top part and the bottom part to the tibia, some doctors dont touch the fibula(incompetent), some doctors affix only the bottom part of the fibula

here are my Xrays:




so, on my surgery the doctor passed one of the lower pins through the tibia and fibula therefore affixing the ankle portion of the fibula with the tibia. the ankle portion is what matters in the end because its what gives your ankles stability when walking/running

however, yes the fibula curved towards the tibia

this is not the end position of this fibula though, because since there is union in my fibulas, they will initially heal in this position you see from the xrays, HOWEVER, over time and due to weight bearing stress(daily walking), the bone will modify itself and straighten itself out

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Quote from: boklecrt on August 25, 2022, 12:55:16 AM
i propose we stop saying HJ - that sounds like a hand job


so basically with the fibula - it can go in many different ways due to the fixation - some docs like assayag screw the top part and the bottom part to the tibia, some doctors dont touch the fibula(incompetent), some doctors affix only the bottom part of the fibula

here are my Xrays:




so, on my surgery the doctor passed one of the lower pins through the tibia and fibula therefore affixing the ankle portion of the fibula with the tibia. the ankle portion is what matters in the end because its what gives your ankles stability when walking/running

however, yes the fibula curved towards the tibia

this is not the end position of this fibula though, because since there is union in my fibulas, they will initially heal in this position you see from the xrays, HOWEVER, over time and due to weight bearing stress(daily walking), the bone will modify itself and straighten itself out

Very interesting post thank you, also for the x rays to see.
I did not know that they attached pins to the fibula as well. I always wondered about that. It is not many tibia lengthenings that include this bit, I don’t remember seeing it before, or am I remembering wrong?

The last part about the bone over time modifying itself and straightening out as well is very interesting. Do we know for sure this is a fact? I apologize if I sound rude here, I am not saying this is not true, I am just amazed if this works it would be perfect, but I can imagine this is complicated as it would depend on the patient walking a lot early, and maybe also on the patient not lengthening too much?

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Quote from: TheDream on August 25, 2022, 10:08:58 PMVery interesting post thank you, also for the x rays to see.
I did not know that they attached pins to the fibula as well. I always wondered about that. It is not many tibia lengthenings that include this bit, I don’t remember seeing it before, or am I remembering wrong?

The last part about the bone over time modifying itself and straightening out as well is very interesting. Do we know for sure this is a fact? I apologize if I sound rude here, I am not saying this is not true, I am just amazed if this works it would be perfect, but I can imagine this is complicated as it would depend on the patient walking a lot early, and maybe also on the patient not lengthening too much?


the phenomenon of bones straightening themselves out over time depends on the severity of the initial fracture

the fibula is not affixed like the tibia with a nail or a plate so it will heal the way the body pushes it to heal. by walking and exerting stress on it while its still calcifying it will move in the direction where the stresses push it to

in the xrays, the position is not straight, so if after 1 year it has not migrated back to its original straight position and consolidates in the position of the xray, it will be possibly considered fibular malunion. if that happens to me i can get a quick surgery to get it realigned if my doctor thinks its medically necessary(if i have pain, instability or a risk of early arthritis). but since im now about 6 weeks after this xray and in total 4 months into recovery from frame removal and my ankles feel very stable that tells me that the fibula is not presenting issues for now so we will see on my 6 month xray whats going on with it. ideally it should have started moving back to straight position

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Day 43 – Bi-Weekly Appointment with X-rays, +2.55cm (1.00 inch)

https://heightjourney.wordpress.com/2022/08/27/day-43-bi-weekly-appointment-with-x-rays-2-55cm-1-00-inch/

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Quote from: boklecrt on August 25, 2022, 12:55:16 AMi propose we stop saying HJ - that sounds like a hand job

It's okay to refer to me as HJ, because the first thing when everyone else thinks HJ means is Height Journey.

If the word "hand job" first comes to your mind when seeing HJ, it gives us a clue of what your private lifestyle is like. But I'm not here to judge or pry into your private lifestyle.

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HJ, thanks for sharing your experiences. What is the picture in your profile? Grey purple plastic looking thing? Something used in PT maybe?

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Quote from: EndGame on August 28, 2022, 03:58:35 PMHJ, thanks for sharing your experiences. What is the picture in your profile? Grey purple plastic looking thing? Something used in PT maybe?

It's the electronic magnetic controller (ERC) used to lengthen the Precice internal nail.

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Day 45 – Review of Week 5, Foot Supination, +2.65cm (1.04 inch)

https://heightjourney.wordpress.com/2022/08/28/day-45-review-of-week-5-foot-supination-2-65cm-1-04-inch/

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Day 50 – Review of Week 7, Muscle Tightness and Pain, Astym Treatment, Updated Goal, +2.90cm (1.14 inch)

https://heightjourney.wordpress.com/2022/09/02/day-50-review-of-week-7-muscle-tightness-and-pain-astym-treatment-updated-goal-2-90cm-1-14-inch/