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[Disobedient]

Hi guys,

I want to share shorty's x-ray he had it few days ago.., and I would love to know your opinion,
do you think his callus formation is good enough to remove the fixator right now?

it has been about 5 months post operation..he did about 5cm, 2.5cm in tibia, and about 2cm in femur,.. and  stopped lengthening 2 months ago, but he started distraction again a week ago in his tibia..
Do you think the restart of distraction again would cuz non-reunion for his tibia, he wants to add another 3cm, or he has to have another surgery to re-breake the bone again ?   ..


these are his x-ray..

Left tibia



Right tibia



Left femur








Right femur

[crimsontide]

Should be asking a Dr these questions, not us

[alps]

His femurs are messed up!
And why did he stop for 2 months like that?

[KiloKAHN]

He should consult with another orthopedic surgeon in Delhi. Try Dr Dhawan at Sir Ganga Ram. www.limblengtheningindia.com

[Sweden]

He is messed up for life.
Congratulations.

No, he can't distract anymore.

Darwin awards.

[Medium Drink Of Water]

He can and should start again, with a competent doctor, whether or not he has to have the bone re-broken.

[Carter]

Have a consultation with Dr Naveen Talwar in New Deli and bring all the xrays along. He is qualified to advise Shorty.

[mediocre]

O-M-G!

[Orlando]

Shorty should be posting here himself.  Clearly he's not doing well by suffering in silence.  We could have told him that stopping lengthening at 2cm was a bad idea.

I'm really puzzled why he would do 2 LL to gain only 5cm.  Minimal of  8-10cm seem more worthwhile for all the troubles.  His tibia look to have almost consolidated.  If he wants to do 3cm, he has to lengthen fast or rebreak the bone.  I'm no medical expert so please find a competent Doctor for consultation.

[Disobedient]

Hmm he did 5cm cuz he didn't want to have a lot of complications ..

anyway, so this is Dr.mangal parihar's replay to him,

dear,

1. i would not advise you to undergo any surgical intervention right now. i would advise to let this heal, and then take it forward from there. further surgical interventions at this stage carry risks of regenerate collapse, infection of the internal implant etc.

2. as above.

3. alignment can only be properly and completely judged and recorded, on a full length, STANDING X-ray. if you are not able to stand well, you should concentrate on exercises and physio to regain function, and assessments have to be made at that time.

4. callus seems to be healing at this time.


as far as i know it would be not possible to gain anymore length by distracting now after a a gap of 2 months, without a further osteotomy. if you continue distraction now, you will just be subjecting your fixator to avoidable stresses.


finally, real decisions can only be made after examining the patients.

there may be occasions when the opinions of doctors differ. in that situation, it is better to follow the advice of the treating doctor (who is taking care of you currently)

you should lay more stress on physio and exercises (ambulation, ROM of knee and ankle, pain relief) than gaining length at this time.



best regards

dr mangal parihar

--------------------------

Dr Rah advised him to start dynamisation of Fixator which means loosen one screw in each Fixator  and start to walk full weight baring ..then do x-ray again after 3 weeks..

[KiloKAHN]

Very interesting post, Disobedient.

Regarding dynamization, according to Dr Guichet it can cause between a 2 mm to 7 mm loss in height gain. Just something Shorty should be aware of so he isn't surprised after following Dr Rah's advice if he doesn't end up with a full 5 cm height gain when all is said and done.