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[Medium Drink Of Water]

What I don't like about it is that you're elongating such a thin part of the bone.  Which is more stable, a tree with a thicker trunk or one with a thinner trunk?

[KiloKAHN]

But then you can apparantly get the external frames of within 3 months if you only lengthen 4 cms according to Dr Mirzoyan. But i guess this is with double incision but im not sure. Still that would remove the muscle damage risk. And the pins are not supposed to go through muscle tissue so im not sure why the muscle would get permanently damaged from the frames, i thought muscle aptrophy was the issue, but that can be recovered.

I e-mailed Dr. Mirzoyan a long time ago, like two or three years back, and I remember him saying that he uses two intramedullary wires that speed up the recovery process. I looked at a patient x-ray of his and found what he meant by it. http://www.leglengthening.am/index.php?option=com_content&view=article&id=36&Itemid=38&lang=en). So consolidation might be a bit faster with him than with traditional Ilizarov.

I didn't take a look at the study that Stadiometer found but a few forum members on the other site had mentioned it. I'd like to read it to see what is meant by the permanent muscle damage as well because it is disconcerting.

[Wannabegiant]

What I don't like about it is that you're elongating such a thin part of the bone.  Which is more stable, a tree with a thicker trunk or one with a thinner trunk?

Good point, but since my gaps will be so small (2 cms) i dont think it will matter much, the room for misalignment is pretty small, and i dont think there is any risk that it will break with my frames on as long as i am careful while moving.

Btw can someone give me the email adress to Dr. Mirzoyan, for some reason i seem to be unable to find it on there webpage, which is quite embarassing.

[Medium Drink Of Water]

Yeah, I suppose so.  With only 2cm gaps I don't see much of a problem either.  I forgot how little you were lengthening.

[Wannabegiant]

Yeah, I suppose so.  With only 2cm gaps I don't see much of a problem either.  I forgot how little you were lengthening.

Yeah, and after reading Craig49s diary about his experience in Armenia, it seems most of his problems came from his femur. The double incision doesnt seem to cause much trouble, although the cutting method Mirzoyan uses is questionable, as he doesnt make a clean split, rather he "shatters" the bone as he claims it causes more surface area which is better for healing.

This method seems to have led to some problems later for Craig, as the osteotomy cause by the shatter break caused a bump on his ankle break on one of his legs. since it happened on the ankle, the problem might be because the bone is so thin there like you mentioned earlier, or it may simply be that he was unlucky and that the shatter method for breaking bones is bad, (which wouldnt surprise me as he seems to be one of the few who doesnt use a clean split of the bone)

Im not sure if you could ask the Dr about this before proceding, if you could talk him into doing a straight cut instead, or if this is just really unlucky that the osteotomy went bad. Regardless the problem seems fixable even if it happens.

Finally according to craigs diary he was offered to change his ilizarov frame on his femur, into a monorail device. So i guess that must mean that they have those monorails present at the Clinic, so the question is if they are available as a first option if you ask them about it?

I need to question Mirzoyan about it but i am still unable to find his email adress.

[KiloKAHN]

I need to question Mirzoyan about it but i am still unable to find his email adress.

This is the e-mail address for Dr. Mirzoyan that he was responding to.

amirzo@ycllr.org

[Wannabegiant]

This is the e-mail address for Dr. Mirzoyan that he was responding to.

amirzo@ycllr.org

Thank you mate!

[Adriano]

But then you can apparantly get the external frames of within 3 months if you only lengthen 4 cms according to Dr Mirzoyan. But i guess this is with double incision but im not sure. Still that would remove the muscle damage risk. And the pins are not supposed to go through muscle tissue so im not sure why the muscle would get permanently damaged from the frames, i thought muscle aptrophy was the issue, but that can be recovered.

Atually this is a very interesting discussion. I have bn thinking that this discussion is start to annoy me but I has given me 2 great ideas.

if u can get 4cm and be out of externals in 3 months doing external only then one could do this and come back for me a yar later for another 4 cm.

total time in frames will be 6 months
you would not be risking permanent knee pain that associated with LON & LatN

its easier to take 3 months break from whatever you r doing (rather than 6 month or more that you need with LON and LATN)

ppl wont notice your height increase cos you will be spreading it over a longer time

You also wont get ballerina.

This is a really great idea.



I am thinking of pushing it to the limit by doing internal femur combined with external only and only doing 4cm on the tib.
this would hide the bgi gain that I am aimin for on my femur.

11cm on femur plus 4cm on tibia  (and then come back home 6 inches taller!!!) what a dream lol

that would take me from 5'4 to 5'10

woooowwwww if only it was as easy as this.  But it is Very possible possible

[Sweden]

This is all very sad to read.
You guys will be so messed up. 

Best of luck.

[Wannabegiant]

This is all very sad to read.
You guys will be so messed up. 

Best of luck.

Sweden I appreciate your concern and I know you have great points to consider. But still, after reading through all of craigs diary, it seems clear to me that pretty much all of his problems came from his femur, while the tibia lengthening he did only had one complication, and he was able to solve it quite easily. The bump that was created on one of his ankles as a result of the osteotomy after shattering the bone rather than using a clean split. Seems like bad luck and like it doesnt have much to do with the double incision. Even with double incision you can lengthen slowly if one desires and still enjoy the benefit of faster consolidation, less stretching of tendons and muscle in one place as well.

There seems to be several benefits. And myself having such a simple request in comparison to Craig, I have to believe that i wont be as unlucky as he was.

Btw I sent you a PM, have you had time to read it? i would very much appreciate your insight on that Sweden. Thank you again.

[Wannabegiant]

Also got in touch with Dr.Mirzoyan now, he really is fast to answer!

So the good news is that he does offer unilateral frames (which i assume is the same as monorails), but then according to him he prefers to use the ilizarov as he claims there is more "reliability to prevent deformations and provide maximum conditions for faster bone healing"

What do you think about that guys? On this site the negatives of the monorail seemed to be pretty negliable, but do you think there is high risk for deformation while using them? also even if the bone heals slightly faster with ilizarov (which i cant figure out why it works like that) i would probably prefer to wear the frames slightly longer if it meant they where small so i could hide them from the beginning of the consolidation phase.

[Medium Drink Of Water]

Ilizarov frames are better for doing corrections.  Most people in Beijing had some sort of undesirable angle start to develop at some point during their LL.  The doctors would measure it in x-rays and then tell you to turn the knobs unevenly until it had been resolved.  For example, if the legs were bending inward, you'd turn the inner knobs 1.3mm and the outer knobs .67mm for a few days.

I don't know what he's talking about regarding bone growth.  I've never heard of Ilizarov vs. Monorail making a difference in bone growth.  But keep in mind I'm no doctor, not even a self-proclaimed prophet of LL, so there's things about LL I don't know.  My philosophy is, once you've picked a doctor you should listen to him and do what he says.  You're his patient under his care and need to do things his way, because that's what he has experience with.

[Wannabegiant]

Ilizarov frames are better for doing corrections.  Most people in Beijing had some sort of undesirable angle start to develop at some point during their LL.  The doctors would measure it in x-rays and then tell you to turn the knobs unevenly until it had been resolved.  For example, if the legs were bending inward, you'd turn the inner knobs 1.3mm and the outer knobs .67mm for a few days.

I don't know what he's talking about regarding bone growth.  I've never heard of Ilizarov vs. Monorail making a difference in bone growth.  But keep in mind I'm no doctor, not even a self-proclaimed prophet of LL, so there's things about LL I don't know.  My philosophy is, once you've picked a doctor you should listen to him and do what he says.  You're his patient under his care and need to do things his way, because that's what he has experience with.

Alright thanks mate, but those undesirable angles, I guess that is mostly a problem when lengthening a big ammount right? i have a hard time imagining myself getting bowlegs or cowlegs from lengthening 4 cms, especially if it is from two cuts. But are corrections impossible with monorail? or just harder?

Yeah I guess if he is saying it is better for bone growth its probably true, but still being able to hide the monorails from the beginning and wearing them for maybe 4 months would be preferred over wearing ilizarov frames for 3 months and not being able to hide them.

Its a pretty big trade off, and i think monorail is optimal here, especially since im lengthening so little.

[Medium Drink Of Water]

Right, the more you lengthen the more likely you'll need a correction.  With monorails it's not easier or harder to do corrections, it's either the same (little corrections) or impossible (big corrections).  If your legs get too out of line with monorails, then all you can do is leave it like that or have a surgical correction.

I'm not sure about whether the double cut increases or decreases the chance of misalignment.  One one hand you've got smaller gaps, however the gaps are where misalignments happen.

[Wannabegiant]

Right, the more you lengthen the more likely you'll need a correction.  With monorails it's not easier or harder to do corrections, it's either the same (little corrections) or impossible (big corrections).  If your legs get too out of line with monorails, then all you can do is leave it like that or have a surgical correction.

I'm not sure about whether the double cut increases or decreases the chance of misalignment.  One one hand you've got smaller gaps, however the gaps are where misalignments happen.

Makes perfect sense to me then, yeah i think a big correction is very unlikely to be needed when lengthening 4 cms. Hopefully. And yeah agreed with the double cut it seems like its +/- = 0, in terms of added risks as long as i dont lengthen to fast. So i might as well do it for the faster consolidation time.

[Taller]

Wannabegiant, have you had any luck contacting Dr. Mirzoyan recently? Are you considering writing a patient experience? Also, make sure that the monorail devices used have a decent number of pins (4 or more per cut in each bone, two+ pins on each side of the cut to prevent the bone from shifting and rotating around the pins). The more pins you have, the lower the chance of your leg getting misaligned. You should also be aware that scars from monorail devices can be pretty unsightly and deep. Best of luck and happy new year!

[Wannabegiant]

Wannabegiant, have you had any luck contacting Dr. Mirzoyan recently? Are you considering writing a patient experience? Also, make sure that the monorail devices used have a decent number of pins (4 or more per cut in each bone, two+ pins on each side of the cut to prevent the bone from shifting and rotating around the pins). The more pins you have, the lower the chance of your leg getting misaligned. You should also be aware that scars from monorail devices can be pretty unsightly and deep. Best of luck and happy new year!

I promise to write about my experience as i lengthen, and will probably keep posting until I am fully recovered, so you know all the details. But i will probably post some pics of the clinic and my legs, but im probably not gonna post x-rays or many pics of myself (i want as much anonymity as possible) and I already did mockups and the added 4 cm barely has any effect on my proportions, since I have very long arms, I think the longer legs might actually be beneficial to my proportions, though i think my torso is average or slightly below average in height for someone that is 175 cm tall.

And yeah Dr Mirzoyan responded within a day to my mail I sent him, He said I could come anytime, so im planning to go there late februari this year.

Alright thats great info about the pins, I will remember that and talk to Dr. Mirzoyan about it, maybe i will post a picture of it here if im able to later and you can determine if it looks like a good option. If it lacks many pins i will go for ilizarov probably. Yeah the scars is not so bothersome for me, there are ways to get rid of them (or most of it at least).

Thank you and happy new year!

[Taller]

Awesome. We will all be rooting for you!

[Wannabegiant]

Awesome. We will all be rooting for you!

Thanks!

So all i really need to do now is book the flight, I guess one-way ticket is the way to go, cause i cant really know how long the lengthening process will be.

A few more questions arised though, if you guys know i would appreciate it.

1. should i talk to a doctor here in Sweden before i go to Armenia, and let them know about what I am going to do with my legs? The reason I ask is because i wonder if I still have the right as a tax payer, to get physical therapy and aid for my legs when I get back home even though I inflicted damage on my legs for aesthetic reasons?

2. What can i do to minimize pin bending?, i guess since i dont weigh to much (64 kg) the weight bearing wont be to bad on the pins.

3. is calcium and vitamin D supplements recommended during lengthening phase? im sure it will be useful during consolidation phase, but during lengthening maybe it could increase risk of to early bone union or something?

Thanks again in advance

[Medium Drink Of Water]

2. What can i do to minimize pin bending?, i guess since i dont weigh to much (64 kg) the weight bearing wont be to bad on the pins.

3. is calcium and vitamin D supplements recommended during lengthening phase? im sure it will be useful during consolidation phase, but during lengthening maybe it could increase risk of to early bone union or something?

You could never stand on your frames, that would minimize pin bending, but that's not recommended.  When your pins bend, you can just turn more, since you didn't actually lengthen your legs by how much you thought you turned.

Non-union is a much worse problem to have than premature consolidation.  I took the supplements during LL.  If you're clearly not going to suffer from non-union according to your doctor then you can stop taking them though.

[Wannabegiant]

You could never stand on your frames, that would minimize pin bending, but that's not recommended.  When your pins bend, you can just turn more, since you didn't actually lengthen your legs by how much you thought you turned.

Non-union is a much worse problem to have than premature consolidation.  I took the supplements during LL.  If you're clearly not going to suffer from non-union according to your doctor then you can stop taking them though.

alright thank you

I just thought about this as well, when i return home for the consolidation phase, could i do the physical therapy exercises by myself and eventually recover fully? or do i need proffessional help from an orthopedic doctor?
Also will i be able to remove the frames by myself or do I need the orthopedic help for that as well? I guess I would have to get x-rays of my legs every now and then to see if my bones are fully consolidated to know when to remove the frames.

[Medium Drink Of Water]

Walking cures most problems caused by LL.  My opinion of physical therapists and LL is that you only need to go to one if you're having a specific problem that doesn't seem to be getting better on its own.  That's what I did; my right ankle wasn't having good flexibility so she showed me some stretches I could do to make it catch up to the left one in terms of mobility.

I know patients could remove the Mitkovic monorail fixator on their own, but check with your doctor about what you can do yourself and what you can't with the fixator he'll be using.  Once you're done lengthening, take x-rays every 3 months and send them to your doctor so he can tell you when it's safe to remove the frames.

[Sweden]

You can't wear pants over the monorail so you know.

You are taking a seriously huge risk.

They can help you with everything you need in Sweden too, no need to send X-rays.

I'm not sure Mirzoyan will let you leave with the monorails on your legs.

[Wannabegiant]

Walking cures most problems caused by LL.  My opinion of physical therapists and LL is that you only need to go to one if you're having a specific problem that doesn't seem to be getting better on its own.  That's what I did; my right ankle wasn't having good flexibility so she showed me some stretches I could do to make it catch up to the left one in terms of mobility.

I know patients could remove the Mitkovic monorail fixator on their own, but check with your doctor about what you can do yourself and what you can't with the fixator he'll be using.  Once you're done lengthening, take x-rays every 3 months and send them to your doctor so he can tell you when it's safe to remove the frames.

Okey awesome, so walking and some of those stretching exercises that are displayed in that video we have on this site should be enough unless i get some specific lingering problem then i will get some help from a proffesional. Alright sounds good with the x-rays too. Thank you for all the info 

 

[Wannabegiant]

You can't wear pants over the monorail so you know.

You are taking a seriously huge risk.

They can help you with everything you need in Sweden too, no need to send X-rays.

I'm not sure Mirzoyan will let you leave with the monorails on your legs.

Some pants should work I would think, like some really wide soft pants? or are you not allowed to because it might interfere with the pins and stuff?
Okey so they will still help me even with them knowing that I intentionally broke my legs for aesthetic reasons, thats cool I was a bit worried about that.

I know of one of Mirzoyans patients who left with the ilizarov frames on him, but if he thinks its to risky to go home before i can remove the frames then there is no advantage for me using monorails, then i might as well take the ilizarovs and hide in my home for 3+ months. But I dont think there should be a problem leaving with monorails either, il only know for sure when I ask him I guess.

Thanks for the help, I appreciate it 

[Wannabegiant]

Okey i tried to find some videos of people walking with ilizarovs and monorails post op, but im not sure if the few i found was of patients during lengthening phase or consolidation phase.

So a few questions regarding the unilateral frames and external frames in general:

1. Can you wear clothes over the monorails? the faq says you can, but im not sure how big the monorails are as they seem to vary in size, do you think its possible to hide them with wide pants?

2. How well will I be able to walk during consolidation phase with the frames on? After I have lengthened 4 cms, according to Mirzoyan the bones should have healed after about 3 months. So will i limp with the frames on, or maybe like after a month of consolidation will I be able to walk decently normal? I guess this depends on the individual, but id like a general idea how much the fixators restrict your movement and if the bones are so fickle at this point that you have to be super careful when walking.

3. When i finally remove the fixators, how weak can i expect my legs to be? will i be able to run at this point and jump? or will i still have to be careful ( I would assume the bones are as strong as before surgery or stronger at this point) for some time until I recover more? I guess this is individual as well.

Thanks in advance

[Medium Drink Of Water]

Okey i tried to find some videos of people walking with ilizarovs and monorails post op, but im not sure if the few i found was of patients during lengthening phase or consolidation phase.

So a few questions regarding the unilateral frames and external frames in general:

1. Can you wear clothes over the monorails? the faq says you can, but im not sure how big the monorails are as they seem to vary in size, do you think its possible to hide them with wide pants?

2. How well will I be able to walk during consolidation phase with the frames on? After I have lengthened 4 cms, according to Mirzoyan the bones should have healed after about 3 months. So will i limp with the frames on, or maybe like after a month of consolidation will I be able to walk decently normal? I guess this depends on the individual, but id like a general idea how much the fixators restrict your movement and if the bones are so fickle at this point that you have to be super careful when walking.

3. When i finally remove the fixators, how weak can i expect my legs to be? will i be able to run at this point and jump? or will i still have to be careful ( I would assume the bones are as strong as before surgery or stronger at this point) for some time until I recover more? I guess this is individual as well.

Thanks in advance

1. Yes you can wear baggy clothes over the monorails, but they probably won't be hidden very well.  They're bigger than you might think, at least the ones I saw in Serbia were.

2. The frames will be holding your bones together even if they're broken, so distraction/consolidating/consolidated doesn't matter in terms of walking.  Any issues you have with walking will be due to the trauma from the surgery and the muscles/tendons not being lengthened at the same rate as the bone.

3. Once the bone is fully consolidated, it's fully consolidated, and you can do anything you could before as far as the bone is concerned.  Muscles/tendons stretch and grow at different rates so it's hard to give you a concrete answer about when you can do what.

[Wannabegiant]

1. Yes you can wear baggy clothes over the monorails, but they probably won't be hidden very well.  They're bigger than you might think, at least the ones I saw in Serbia were.

2. The frames will be holding your bones together even if they're broken, so distraction/consolidating/consolidated doesn't matter in terms of walking.  Any issues you have with walking will be due to the trauma from the surgery and the muscles/tendons not being lengthened at the same rate as the bone.

3. Once the bone is fully consolidated, it's fully consolidated, and you can do anything you could before as far as the bone is concerned.  Muscles/tendons stretch and grow at different rates so it's hard to give you a concrete answer about when you can do what.

Awesome,thank you. Its such a shame that the salameh type frame isnt available anywhere else. His price range is way to high for me especially since he is located in germany now. But that type of frame would have been quite easy to hide under clothes i would imagine.

[KiloKAHN]

Wow, there sure seems to be a spike in interest for CLL in Armenia judging by the 40 guests viewing this. Wonder what caused the flood.

[TRS]

Wow, there sure seems to be a spike in interest for CLL in Armenia judging by the 40 guests viewing this. Wonder what caused the flood.

LL Forum has made a new record for the most online with 122  There must be something going on in Armenia that triggered their interest

[Wannabegiant]

This topic was kind of stupid, i made it long ago and im grateful for the help i got but looking back im glad i didnt go to Armenia, now that i know how it feels with these frames and also how many things that you need to think about. I cant believe i considered doing double cut, i wonder if you can even weightbear with that. also 2 mm a day my soft tissue would be destroyed..

With the frames i got from Bagirov i can at least hide them decently.