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[TnaTna]

Hello,

I have been thinking about tibia lengthening for a while, I plan to undergo an operation in India next year (being a student, I can't afford it anywhere else). I have few time and few money, I think 4 cms would be enough for me, so I wonder if it is possible to recover from the operation in a 3 month time : about 50 days of lengthening and 40 days of recovery. My goal is to come back in Europe within 3 months to resume my studies, and to be able to walk without any assistance. I just need to be able to walk 3-4 hours a day (not in a single time). I have a healthy body and I'm quite thin (60 kgs).

Do you think a 3 months process for 4cm on tibias after which need no frame nor crutches is possible ? I mean, imagining no complication occurs. If so, have you got some advice ?

Thank you,

[Penguinn]

No way on tibias with externals. That goal might be plausible with internals but you said money's an issue.

[TrueSpartan]

It usually takes about 1.5 months per cm to recover. For 4cm your looking at about 6 months.

[TnaTna]

That goal might be plausible with internals but you said money's an issue.

With LON, do you think it would work ?

I think the recovery is not proportional to the lengthening : for example if it takes 5 months to recover from 5 cms, then it should takes less than 4 months to recover from 4 cms. And 7 cms may need more than 8 months etc. Perhaps I'm wrong though.

[TrueSpartan]

LON and LATN does not decrease your bone consolidation time. With a locked nail inside, that nail will connect the 2 broke bones and you can put partial weight on them ( assisted weight bearing). However, to start walking unassisted, the bone gap has to fully consolidated and that takes about 1.5 month per cm on average.

[Penguinn]

You can't set a strict time limit for something like LL,   can go wrong.

[Cheez]

I didn't do LL yet myself, but from everything I have read so far (and that has been a lot over the last two weeks), you should give yourself and your bones some time to heal, or things will get really nasty.

if you are not having that time, maybe you should consider doing this a few years later. If you are a student, you are probably still quite young, so no need to hurry.

[Knik]

So one year is good for a good recovery ?

[berkeclor123]

Not even man. You will have to use crutches for a while. Just make up a story. I am thinking of doing the same thing but it is highly unrealistic for me even though I know I am at the peak of physical fitness. 3 months for 5 cm for me would not be even real, being able to walk unassisted to continue working. lol

[TnaTna]

Hum, I may be too optimistic indeed.
I have read this diary : https://www.reddit.com/r/short/comments/1ugx1y/im_a_guy_who_just_completed_three_months_of_leg/

7,5 cms, 3 months of lengthening, he was able to walk more than 30 min without cruches the 1st May, 4 months after the lengthening was over (7 months since the operation).
I'm not talking about full recovery, but only the ability of walking without any device.
In the no complication case, if it takes 7 months for 7,5 cms, it would be surprising 4 cms need 6 months of recovery as TrueSpartian said, hum ?

Alas, I only read diaries of 5 cms +, 1,5 cms of recovery per month in average may be a data made from these long lengthening experiences, I do think the body tolerates much more easily a 4/3 cms lenghtening.

If somebody has read - 5 cms lengthening diaries somewhere, sharing it would be appreciated.
 

[TrueSpartan]

Hey Tnak,

I wish you were right and recovery was much faster but unfortunately these figures have been provided by many surgeons. Best case scenerio is about 1cm per month. Slow consolidation scenerio is about 2cm per month. Average is 1.5 cm per month.

There is a Russian diary of wannabe giant who did 4.something cm. His surgury was March 1st. Frame removal was October. About 8ish months. You can not do this in 3 months and walk unassisted.

[ub40]

I'm sorry man but you are being very optimistic. Also, India isn't the only cheap alternative, there has been some serious horror stories from that country. I would be very careful. Are you from there?

[Bigfaker]

I've seen this type of question posed a few times now Tnak10 and every time I see it, I sort of cringe.

It's kind of like saying "I'm going to temporarily destroy my body and incapacitate myself, but I don't have a lot of time to do it and recover"

Personally, I'm not saying it's absolutely impossible, though. We had one guy (Patient 2) in our guest house lengthen just over 6cm (though he thinks he ended up around 5.5 of gain after getting home) in 3 months, then walk very slowly about a month after that. Thats's ONE guy out of 10, though. A couple others healed pretty quickly, but P2 was a freak, healing-wise. I can't tell you much about what he did to recover so quickly. He was a smoker, even. He did eat well and he took spirulina regularly.

Then there's another patient and myself who are still struggling to recover from complications over 2 and a half years later (for very different reasons). But as hard data goes, this is all just anecdotal evidence and an incredibly small sample size. You may not be able to even find many patient histories of LL'ers doing less than 5cm (I don't think it would be worth the pain, expense, and hassle). And from (reading about) people who have done around 5, I think what all of these guys who responded before me are saying is: it is highly unlikely.

Whatever you decide: if I were you I would VERIFY being completely healthy before lengthening. Had I to do all over again, I would have better addressed my ankle issues and I would have gotten a blood test with chem panel and enzyme markers. I can't say if I had my Vitamin D deficiency when I went to India, but I sure as hell would have been pounding the supplements had I known about it.

[ub40]

Bigfaker, did you have none union problems? And can you clarify about the ankle issues?

[Bigfaker]

Hey ub,

25 months after frame removal, I still have non-union...well, my new ortho is calling it "partial non-union" of the anterior tibias. Because I got impatient with still using a crutch a year after frame removal, I was probably walking unaided too soon. My doc thinks it's possible one or more of the screws in the L nail is slightly dislodged. The rod itself seems OK. So the docs in India (in particular Sarin) were correct that the weakest link to worry about were not the nails, but the screws.

I can fully weight-bear on either leg. The tib/fib are pretty strong on the R side, but I have the ankle issue hampering it (more below). The L leg was muuuuuuuch slower to heal and is still weaker to this day. I used to have pain in the locking screw, but now the pain is just focused in the knee. I can fake a normal gait if I really concentrate, but usually it looks more like I'm limping. After a couple hard hours in the gym or doing martial arts, I can barely stand and resort back to the crutch when I get home.

Anyway, I was presented with 2 options to promote bone growth in my L leg: Masquelet graft or revision nailing. Because ortho thought the chances of success were about equal, I chose the latter because it's only one procedure instead of two. I just had my pre-anesthesia consult yesterday and my surgery is this Thursday the 12th.

The ankle issues were not really related to LL originally. They go WAAAAY back to a kickboxing injury in 2006. After that, I would supinate my R ankle (roll inward) about once a month, causing a mild to moderate sprain. I didn't have health insurance back then, so I never got around to having it checked out thoroughly until mid-2013, when I knew I would be starting my LL journey soon. The podiatrist/foot surgeon I saw that year said I had probably fractured something in there years ago, and I had bone fragments floating in there. I did some PT on it that year, but it didn't really improve much. I think I convinced myself everything was going to be OK. It was not really affecting me too badly: I could run and jump, I could kickbox, I could play basketball. None of the 3 docs in India seemed to think it would matter -- I recall Parihar and Sringari testing my flexibility (Sarin and I only spoke at the guest house) -- probably because I didn't walk with any limp (back then) or noticeable sign of the issue. 

Fast-forward to 2015 and the ankle was still KILLING me post-lengthening. I was usually on one crutch at this time (to support the weak L leg), but too much exertion would put me back on two. By then, three different podiatrist/foot surgeons had given three different diagnoses. The first (in 2013) had said I "probably had fractured it long ago". A second (in 2014) said I had an"obviously fractured talus". A third, later that year, got a CT and MRI and said there was only soft tissue damage. He gave me a Cortisone injection in (I think) January of 2015. I had surgery with this third doc a couple months ago, on February 22nd. He said he could only debride dead scar tissue and cartilage and there were no bone fragments in that area (below the malleolus) he could remove.

Two months later, it feels a bit better, but not really noticeable. I went for a post-op check on Monday and he gave me a second cortisone injection. So the saga continues...

Sorry for taking up so much room in your topic, Tnak!

[ub40]

Hey ub,

25 months after frame removal, I still have non-union...well, my new ortho is calling it "partial non-union" of the anterior tibias. Because I got impatient with still using a crutch a year after frame removal, I was probably walking unaided too soon. My doc thinks it's possible one or more of the screws in the L nail is slightly dislodged. The rod itself seems OK. So the docs in India (in particular Sarin) were correct that the weakest link to worry about were not the nails, but the screws.

I can fully weight-bear on either leg. The tib/fib are pretty strong on the R side, but I have the ankle issue hampering it (more below). The L leg was muuuuuuuch slower to heal and is still weaker to this day. I used to have pain in the locking screw, but now the pain is just focused in the knee. I can fake a normal gait if I really concentrate, but usually it looks more like I'm limping. After a couple hard hours in the gym or doing martial arts, I can barely stand and resort back to the crutch when I get home.

Anyway, I was presented with 2 options to promote bone growth in my L leg: Masquelet graft or revision nailing. Because ortho thought the chances of success were about equal, I chose the latter because it's only one procedure instead of two. I just had my pre-anesthesia consult yesterday and my surgery is this Thursday the 12th.

The ankle issues were not really related to LL originally. They go WAAAAY back to a kickboxing injury in 2006. After that, I would supinate my R ankle (roll inward) about once a month, causing a mild to moderate sprain. I didn't have health insurance back then, so I never got around to having it checked out thoroughly until mid-2013, when I knew I would be starting my LL journey soon. The podiatrist/foot surgeon I saw that year said I had probably fractured something in there years ago, and I had bone fragments floating in there. I did some PT on it that year, but it didn't really improve much. I think I convinced myself everything was going to be OK. It was not really affecting me too badly: I could run and jump, I could kickbox, I could play basketball. None of the 3 docs in India seemed to think it would matter -- I recall Parihar and Sringari testing my flexibility (Sarin and I only spoke at the guest house) -- probably because I didn't walk with any limp (back then) or noticeable sign of the issue. 

Fast-forward to 2015 and the ankle was still KILLING me post-lengthening. I was usually on one crutch at this time (to support the weak L leg), but too much exertion would put me back on two. By then, three different podiatrist/foot surgeons had given three different diagnoses. The first (in 2013) had said I "probably had fractured it long ago". A second (in 2014) said I had an"obviously fractured talus". A third, later that year, got a CT and MRI and said there was only soft tissue damage. He gave me a Cortisone injection in (I think) January of 2015. I had surgery with this third doc a couple months ago, on February 22nd. He said he could only debride dead scar tissue and cartilage and there were no bone fragments in that area (below the malleolus) he could remove.

Two months later, it feels a bit better, but not really noticeable. I went for a post-op check on Monday and he gave me a second cortisone injection. So the saga continues...

Sorry for taking up so much room in your topic, Tnak!

Sorry to hear about that bigfaker

Who was your doctor if you don't mind me asking?

Also, do you happen to be a smoker. I have heard good things about a bone graft. Please feel free to PM me if you don't want to post it here. I am curious about your complications as I am in the process of CLL myself

[TrueSpartan]

His doctor was Dr. Sringari. He's closer to 40s and had an ankle injury prior to surgury as well as a vitamin d deficiency. His diary can be found on the old forum.

[Bigfaker]

ub,
No, I've never smoked a cigarette, cigar, pipe, joint, hookah, or bong in my life...maybe a bit of second-hand from parties LOL. The beginning of my diary is only on EmEmTee, but I actually rebooted it here, so feel free to post me questions on it if you think anyone else might benefit. Otherwise, PM is fine too. I'll be glad to help if I can.

Spartan, your commission check's in the mail. 

[TnaTna]

I'm sorry to hear your story Bigfaker.

I guess I will have to take much more time, I wanted to do it the quickest as youth probably helps to recover quickly.
I read two diaries of 4 cms tibias lengthening, it's not very good, I hope those whose operation did go very well, like the patient 2 you were talking about, don't go on forums to tell their story and resume as fast as possible their life wishing to forget about all of it.