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[jerkey]

Hi,

I was wondering for those patients who did quadrilaterals with non-fitbone (ie. no reverse planning) how you guys managed valgus x-legs? I read in IamReady's diary that Dr. Paley first operated on his tibia, then his femurs. As far as I understand, BOTH tibia and femur causes x-legs and with internals it's not possible to correct it. I am more curious about if you already have perfectly aligned legs and you do femurs, how you can prevent x-legs (or is the 1mm/1cm of medial deviation not that much to cause significant x-legs when doing lets say 5-6cm)?

Again, thanks and cheers!

[Body Builder]

Very good question. I'd like to hear the opinions of the ones especially who did internal femurs as I want to do too and my biggest concern is x legs.
Also, does fitbone correct malunions? If yes then it is the most superior internal nail but I can't understand how it does it since it just lengthens straightely. Does it has any other function?

[DreamKamchatka]

there should be xleg correction surgery

[realpatient]

Fitbone doesn't prevent misalignment in bad hands. There are patients with straight limbs who got misaligned limbs after surgery

[LLSouthAmerica]

Hi,

I was wondering for those patients who did quadrilaterals with non-fitbone (ie. no reverse planning) how you guys managed valgus x-legs? I read in IamReady's diary that Dr. Paley first operated on his tibia, then his femurs. As far as I understand, BOTH tibia and femur causes x-legs and with internals it's not possible to correct it. I am more curious about if you already have perfectly aligned legs and you do femurs, how you can prevent x-legs (or is the 1mm/1cm of medial deviation not that much to cause significant x-legs when doing lets say 5-6cm)?

Again, thanks and cheers!

This is an interesting topic for me. I understand why femur causes x-legs but in the case of tibia in which the anatomical and mechanical axis are the same, why would internal lengthening cause valgus? I had a 3° valgus before lengthening and afterwards, I can't say I notice any difference. I'm waiting until 6 months or more to do a full scan and understand the changes in my biomechanics as well as any possible valgus which can predispose to osteoarthritis. However, I can't seem to find how much of a valgus entails a risk of osteoarthritis and the degree of valgus (whether severe or moderate)

[Body Builder]

Tibia LL if done correctly won't cause varus or valgus.
That's why we talk about femur LL or quadrilateral lengthening.

[realpatient]

Cases of femur and quad definitely cause X-legs no matter what nail. Fitbone doesn't prevent anything when it's badly used.

[Body Builder]

Cases of femur and quad definitely cause X-legs no matter what nail. Fitbone doesn't prevent anything when it's badly used.

We don't talk about bad use bad generally.
The other nails on femurs cause some degree of x legs no matter what. Has the fitbone any different function to lengthen and correct the bone at the same time?

[realpatient]

That's bull

[Body Builder]

That's bullcrap

And you must be idiot.

[biggerdreams]

Can someone tell me or link me to how quad LL causes xlegs?

[LLSouthAmerica]

Tibia LL if done correctly won't cause varus or valgus.
That's why we talk about femur LL or quadrilateral lengthening.

Yes, I know, but he said BOTH tibia and femur internals cause x-legs which is not true. I got confused.

[TIBIKE200]

Yes, I know, but he said BOTH tibia and femur internals cause x-legs which is not true. I got confused.

It's Lluser, datum.. Ignore

[LLSouthAmerica]

It's Lluser, datum.. Ignore

Check this out, I found this video on youtube by Dr Rozbruch. It is very simple, easy to understand and may be useful for those who think they have knock knees due to LL.

[Body Builder]

Check this out, I found this video on youtube by Dr Rozbruch. It is very simple, easy to understand and may be useful for those who think they have knock knees due to LL.

This is the way to fix misalignments after LL. I have the same plate in my right tibia as I did correction 3 months before together with at shortening surgery.

But what we want to know is if internal femurs cause x legs in every patient or it can be avoided.
If you want to do another surgery to fix it is another topic, the thing is if you can avoid it on the first time and not go for extra surgeries which mean extra time, money and much pain. My tibia fixing was 10 times more painful than LL which was almost painless for me.

[doomsday]

As far as I know femurs are mostly straight that's why you can use internals without much of a problem. Tibia got natural curvature which causes X leg but again, apparently according to Dr Lee that can be also minimalized with appropriate nail positioning.

[Overdozer]

https://www.researchgate.net/publication/230763290_The_effect_on_mechanical_axis_deviation_of_femoral_lengthening_with_an_intramedullary_telescopic_nail

[Avrilinvan]

Could you tell me how much does this correction surgery cost?

[Winterishere]

I am currently doing internal femurs with Dr Paley and have almost finished my lengthening phase. I have not experienced any x-legs at all.