Limb Lengthening Forum
Limb Lengthening Surgery => Limb Lengthening Discussions => Topic started by: GROWtalORdieTRYING1 on October 02, 2014, 02:33:46 PM
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If hydroxyapatite screws are used, we recommend limiting weight bearing to 20–30% bodyweight in the first 6 weeks after surgery to permit bonding between the screws and bone. Thereafter, the patient is permitted to bear weight as tolerated; this functional loading is known to increase the blood supply through the limb [8].
Physiotherapy regimes assist in the gradual and supervised return of weight bearing as well as maintenance of joint movement range and control. Lengthening for congenital pathologies deserves special mention; the soft tissues are most resistant to lengthening, and it is advisable to keep the target lengthening to less than 15% of the original length of the limb.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2994627/ page 5
I have started to come to the opinion that full weight bearing within the first 6 weeks should be avoided. I have heard several doctors say this now. what do people think about this issue. when do people think is the most beneficial time to start short duration full weight bearing. I also think that if you are lengthening femurs or tibia with monorail that it is further incentive to not use full weight bearing even if the nail states that it has full weight bearing capacity. the last thing you want is a misalignment(with monorails) if it can be avoided by not weight bearing more than 30%.
opinions?
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Internal-problems, lol. I started weight bearing 100% right after I woke up after the surgery. I could walk without crutches too. Weight bearing is also proven to increase blood supply and callus formation. Also, by walking without crutches or at least with them and not with walker you're increasing muscle usage and thus preventing them from atrophying.
EDIT: Oops, it's about rail-fixators. Well, they're just as bad for weight bearing as internals, I guess.
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It is really going to totally depend on what technique you are using. You can generally start weight-bearing pretty early with internals, especially PRECICE or the Guichet nail.