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[YellowSpike]

I am preparing for a tibia LL of about 3.8cm (1.5 inches, to get me to a solid average height of 5'9.5"). I would do 2 inches, but willing to compromise since tibias take millions of years to heal. The main issue for me is time.

I know there are plenty of tibia diaries out there, but there are so many, I don't know where to begin. I am probably going to do what Cooper is doing (almost verbatim the same path, he did 6.5cm on femurs first) and go to Dr. Monegal and do Fitbone internal tibias.

I have some general tibia LL questions:

1. How is the pain level for internal tibs? I guess really only those who've done both internal femurs and internal tibias can really compare, but it seems that they're somewhat less painful (and you can sleep better) than internal femurs.

2. What is the physical therapy like (what do they have you do throughout lengthening)? From what I know, tibias behave differently than femurs, so I would imagine the therapy is going to be different.

3. This is what I'm most scared to ask, but about how long would consolidation take for an inch and a half? I spoke with one doctor and he said he believes I could be weight bearing after about 2 months post op (about 1 month distraction and then 4 more weeks on crutches). This is if I did an internal method, which I will be doing. But this still sounds way too good to be true...

4. Are tibias more risky to lengthen in the sense that as you're lengthening and consolidating, your legs don't have a solid base? I know when I was doing femurs and going up and down stairs, I never felt truly "at risk" because I at least had solid tibias to fall back on. This part worries me a bit.

[Medium Drink Of Water]

Stairs are a big obstacle for tibial LLers because of your Achilles not stretching as fast as the rest of your body.  It's really that the feet aren't able to flex enough to navigate the stairs.

[YellowSpike]

*Correction - I meant the doctor I spoke to said I could maybe be partially weightbearing in 2ish months for 3.5cm (not 3.8cm).

Thanks MDoW. Does that continue to be an obstacle after the lengthening process is over? Do you think this would be a huge issue for me given that I'm doing a very small amount (3.5-3.8cm)?

[YellowSpike]

Just wondering if anyone has any additional feedback? I want to make sure I'm going into this with my eyes wide open.

I'm also wondering about the implications of doing tibias after already having done femurs? I know not many on here have done both, but still wanted to put this out there.

[Medium Drink Of Water]

Thanks MDoW. Does that continue to be an obstacle after the lengthening process is over? Do you think this would be a huge issue for me given that I'm doing a very small amount (3.5-3.8cm)?

It did continue to be an obstacle, for months actually.  Going down stairs was the last ability I was able to regain.  Up isn't so bad, though.  I have no idea how much of a problem it'll be for you in light of your doing half what I did.

[YellowSpike]

Thank you, MDoW. If there's anyone I trust with questions on tibia LL, it's definitely you!

I'm also going to be doing an internal method to (hopefully) be able to weight bear sooner. Hoping to do 1.5 inches, but willing to even do as low as 1.25 inches, as I'll still be safely over 5'9" at night (and I can live with that).

The main concern for me is consolidation time. That's going to be a b*tch. I'm trying to prepare myself for the fact that I might have to sacrifice my job over this. 2 months maybe I can pull off, but not sure I can get 3 months off, even with disability...especially because I don't know if the doctor will be able to spin it in a way that I "needed" this (we used my "bow leggedness" the first time around).

[jfk]

I am preparing for a tibia LL of about 3.8cm (1.5 inches, to get me to a solid average height of 5'9.5"). I would do 2 inches, but willing to compromise since tibias take millions of years to heal. The main issue for me is time.

I know there are plenty of tibia diaries out there, but there are so many, I don't know where to begin. I am probably going to do what Cooper is doing (almost verbatim the same path, he did 6.5cm on femurs first) and go to Dr. Monegal and do Fitbone internal tibias.

I have some general tibia LL questions:

1. How is the pain level for internal tibs? I guess really only those who've done both internal femurs and internal tibias can really compare, but it seems that they're somewhat less painful (and you can sleep better) than internal femurs.

2. What is the physical therapy like (what do they have you do throughout lengthening)? From what I know, tibias behave differently than femurs, so I would imagine the therapy is going to be different.

3. This is what I'm most scared to ask, but about how long would consolidation take for an inch and a half? I spoke with one doctor and he said he believes I could be weight bearing after about 2 months post op (about 1 month distraction and then 4 more weeks on crutches). This is if I did an internal method, which I will be doing. But this still sounds way too good to be true...

4. Are tibias more risky to lengthen in the sense that as you're lengthening and consolidating, your legs don't have a solid base? I know when I was doing femurs and going up and down stairs, I never felt truly "at risk" because I at least had solid tibias to fall back on. This part worries me a bit.

Your questions are very hard to answer because there are very few people who did internal tibias (that I know of). There is probably no one on this forum who did internal femurs and after that internal tibias. And then only 3.8 cm in tibias with an internal method. I guess you have to trust your doctor. If he says two months then probably he is right.

I can only answer to your last question. Most of the time I felt stable, but I did external tibias so I am not sure about internals. Only when I had bad ballerina I felt very unstable...

I think you make a good decision to do tibias instead of another femur round. But I think it would be even better if you could accept your height. It is not that bad as it is now. I dont think 3.8 cm is worth to possibly lose your job and spend so much money and break your tibias. But everyone is different. 

It is very brave to do another LL Very few people do that!

[Deads]

You're lengthening around 50% of what most people do on their tibs (6.5-7cm) so you'd have to expect half the recovery time and maybe less because of the compounding effect of such a small amount.. I know it's not always that black and white, but logically your doc makes sense.

[Ellipse Precice]

1. The article titled “Limb Lengthening by Implantable Limb Lengthening Devices” can address your concerns about the pain level for tibia lengthening using internal fixation. Most of the information regarding pain can be found on page 12 (page 83 of the article).
http://www.lengthening.us/files/Limb_Lengthening_by_ImplantableLimb_Lengthening_Devices.pdf

2. A limb lengthening physician who operates using internal fixation can address concerns about pre-operative and post-operative care for your specific situation, including physical therapy.

3. The article will address consolidation for tibia lengthening. Tibias are generally lengthened at a rate of 0.75mm/day as stated on page 6 (page 77 of the article). Your physician will be able to provide guidance regarding weight bearing activities.

4. Once again, the best person to consult is with a limb lengthening physician. They can address your concerns about lengthening and proper post-operative care to reduce your amount of risk.

Here is a surgeon locator with information about the doctors, whom you can contact for more information on tibia lengthening using internal fixation.
http://ellipse-tech.com/find-a-doctor/