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[Doflamingo]

Dear

This is a question that has been asked many times...

It seems that everyone who does LON or LATN ends up with "x legs", even patience from Dr. Donghoon (Youtube).  If you watch it carefully you can see they have a slight x leg, their walking isn't the same as a normal person.

I've seen many pictures of Dr. Sringari's patience and all of them has "x legs" in my eye (Sysop denies this).
I'm pretty sure if there was a miscalculation/coördination during the surgery, causing them to develop knock-knees.

The question is now, will "x legs" ever dissapear?
I don't want to end up having x legs since it can only be fixed with a hip (bone) surgery (if it was a fault of the surgery).

[JP]

Hi

I think after the external fixator is removed they are walking too early and their bone is not strong enough so this is causing x legs because the internal nail don’t help in full weight bearing only in partial weight bearing.

[Polycrates.]

The occurrence of x-legs is indicative of one of two problems. The problem is derived from either a bone misalignment of the long bones in reference to the hip or because of a soft tissue weakness in the legs. If the problem arises from a soft tissue weakness then exercises can be performed to improve the areas requiring more strength. If the problem arises from a skeletal deformity then the only course of improvement would be through surgical intervention.

I'll personally be taking a full frontal weight-bearing x-ray of my legs ASAP, as per the advice of a reputable doctor who frequents this board (Dr. Birkholtz), to determine if the cause of the x-legs I'll be sure to have after frame removal will need to be corrected through surgical means. If my alignment is fine, I'll be at ease, because there are numerous exercise routines available to rectify this symptom.

[Medium Drink Of Water]

I know that at the Beijing Institute, if you start to show signs of x-legs, a doctor comes in and modifies your frames and then tells you to turn the outer knobs a certain amount more so the legs will straighten out.

I would imagine that this is a common issue with Ilizarov fixators because most patients there did end up getting the modification.

[Franz]

True x legs are permanent bony deformities best prevented, as correction will mean bone realignment.
Ilizarov fixators tend to give genu valgum (xlegs) and procurvatum deformities. This is why we use TSF or TLHex rings. This means we can always slot in hexapod struts to do accurate three dimensional corrections with computer software if a deformity occurs.

[Polycrates.]

Doctor,

Are x-legs a deformity occurring from misalignment in the longitudinal axis (as I assume) or the lateral axis of the bone? My legs'  bones appear straight from the anterior x-ray, but there is an obvious misalignment on my right leg in the lateral axis when viewed in a lateral x-ray. My doctor tells me this misalignment is not a risk for deformity. He is not big on attempting any form of correction it seems.

[Polycrates.]

And I'm assuming (as well as hoping) that procurvatum cannot occur over LON, since the nail's rigidity would not allow for such a substantial deviation to occur. Am I correct in this assumption?

[Doflamingo]

@Water, thanks for your answer; only... my budget isn't big enough for Beijing.
@Poly, what does Dr. Sringari do against x legs?
@Frank, I assume you're a doctor? Thanks for the insight, but how can we even get x legs with LON because the rod prevents the bone from bending, no?
@Drew, I wish that's true...

Thanks everyone .

[KiloKAHN]

@Frank, I assume you're a doctor?

Franz is the orthopedic surgeon from this page: http://www.limblengtheningforum.com/index.php?topic=137.0

[Medium Drink Of Water]

Internal nails don't seem to prevent the bone from bending.  old forum  Admin got his bowed legs corrected with LON, and so did another patient I met while I was there.

[Franz]

Hi, the rods only partly prevent deformity, as the proximal segment is so short, they don't grip the bone strong enough to prevent this.
The best way to prevent this is for the surgeon to keep a close eye.

[JP]

I believe that Dr. Sarin and Sringari didn’t fixate the illizarov correctly, and if the patients would walk during the lengthening period the device didn’t help add stability, in my opinion. . this is another reason they have x legs.

[Doflamingo]

Hi, the rods only partly prevent deformity, as the proximal segment is so short, they don't grip the bone strong enough to prevent this.
The best way to prevent this is for the surgeon to keep a close eye.

Thanks Doctor, I'll remember this when It's my turn.