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[YungGud]

Yunggud you know many people that did 10cm in tibias and are not got crippled?

And with an initial height of 1.76 8cm lengthening was an unnecessary risk but fortunately everything went well.

Sibirsky you should have better stayed at 6-6.5 cm to have more proportionate tibias and most of all to not change so much the biomechanics of your feet, as you already had a good initial height and you didn't need so much lengthening but congratulations for your smooth LL trip.

Keep strong!

He did a ridiculous amount at 8 cm yet you ask why he didn't push beyond that....

sorry ,i haven't noticed  that it was on his tibias,my bad

[Body Builder]

sorry ,i haven't noticed  that it was on his tibias,my bad

Εven for femurs 10cm is way too much.

[YungGud]

Εven for femurs 10cm is way too much.

I think for my starting height 8 cm on femurs will be affordable  and within safe zone ,If  he did 8 cm on tibias with almost  same height as me

[Body Builder]

I think for my starting height 8 cm on femurs will be affordable  and within safe zone ,If  he did 8 cm on tibias with almost  same height as me

Every body adapts different to lengthening. And 8cm in tibias is really too much, only 4 months after surgery is too soon to know the final outcome of the surgery.

For your starting height 7cm in femurs would be not very risky and will get you at 6.1 which is an excellent height.
Anything more is an exaggeration and in LL exaggerations leads to major problems.

Sorry for the offtopics I'm stopping it here.

[Sibirsky]

Since I have been given a generous 1-month paid leave from work, I would like to share my joy with the community (also cause I'm bored af). Status update: everything's cool, walking is great and I can now fully squat and go back to standing fully for like 5 times then rest. Still haven't tried running.

Hence during this time, I will be more free to post pics and X-Rays, maybe videos. I prefer uploading many pics in a single post as opposed to multiple posts, its better for readers too. So maybe after like 5-6 replies from the community, I'll post one big post or something like that. I understand some of you may be sceptical of my diary and may have specific requests. That's perfectly fine and now is your chance to ask. But be specific: I have many X-Rays: several taken during lengthening , correction, nailing and during recovery. So you can ask something like I.e X-ray at 5cm or X-ray at 1 month post nailing. There's too much to upload all so yeah, I'll be uploading as per request

Regarding the doctor, I have asked whether I can reveal his name and he's still thinking about it, so I'm not at liberty to disclose his name yet

Anyway, I do look forward to your requests. Cheers to all!

[Sibirsky]

So some scars pic:
https://imgur.com/a/ofrw5

1st one is the whole leg about 3 months post nailing. 2nd one is comparison between type of scar: the smaller one with 2 dots is for the screw for the intramedullary nail, the bigger deeper one is pinsite scar

[Sibirsky]

So a member asked me these questions. I thought it would be great to share with everyone:

"hey man, you and I are the same in regards to height. I am not short, but almost everyone around me is taller.

1) Would you be willing to tell me more about how you feel the procedure has altered your personal health?

2) Do you feel complications in or out of sports?

3)Would you be willing to share your opinion on the recovery aspect?

I do not obsess over height anymore. The obsession was short lived, until I realized how hurtful a high level of stress is. I went brought severe depression so I know myself fairly well.

I hope you are ok with helping me further learn about this procedure, and possibly more about yourself/your journey."

1) In terms of my personal health, I'll try to answer holistically. So physically recovery I would say is going pretty well. Being able to walk completely normally in 2 months post-op is quite rare as I understand it so I am thankful for that. I think I can attribute this to daily physical therapy POST lengthening and nailing, much more than I did during lengthening to be honest. So I think people should emphasise post-nailing therapy.

Mentally however, I'm feeling quite mixed. Socially, I feel more confident with people, often I feel even dominant in conversations. But I feel less satisfied in terms of seeking goals and fulfilment. I simply have lost sight of alternative goals to strive for and be successful because for as long as I can remember, I've worked hard for this surgery, for this change. Now that I have achieved it, I'm in a difficult transition period. Yes, the physical recovery is demanding, but to me the mental demands of moving forward is much more difficult. I'm still looking for motivation to work hard for, because now I feel very unproductive.

2) I can't really comment on sports yet because I can't run yet. But I will get back to you on this in 2 months. Right now it's to early rto comment.

3) Already answered in 1)

[YungGud]

Do you feel  tall enough at your present height?
Do you planning any additional   operation in a nearest future ?

[Sibirsky]

Do you feel  tall enough at your present height?
Do you planning any additional   operation in a nearest future ?

I feel tall enough actually. I fit quite well in terms of height within my circle of family and friends now. So in my country where the average is about 175 cm, I feel tall enough

You might think this will make me not even think about doing a second surgery for femurs. However, as contradictory as it may seem to what I've just said, there is a chance I will. This is because I am afraid of looking obviously disproportionate, with long tibias and short femurs. Some people have noticed this and have commented but do not suspect surgery. But if too many people in the future notice this, even after I have added bulk to my calves post-recovery, I might have to equalise the gains in both femurs and tibias. In relation to other body parts, additional femur lengthening might not cause too much of a problem. My arm spam is 185 cm, sitting height at least 91 cm because I measured when my back was tight and I hunched forward so bad posture.

But as of now, I think the chances of me doing the femurs is only around 10%, mainly because internals are expensive and may distort my leg alignment as well as the fact that I'm already happy in terms of height. In the unlikely case I do decide on femur lengthening, I'll be aiming to reach 190 cm because it wouldn't be worth the high cost and recovery time for less than that 190 cm. Trust me, I don't mean to ruffle anyone's feathers with these answers, it's my honest opinion, though I do appreciate constructive feedback and criticism from everyone

[Peaceout]

Thanks for the diary.
+1 for pictures

[Body Builder]

Doing LL at your current height is insane and it will cause you only problems.
Even your proportions won't look better as your feet would look insanely tall, especially if you lengthen more than 3-4cm in femurs as you said.
And of course it doesn't worth the plenty of money you'll spend as for femurs the only real way of LL is pure internals.

So think more wisely and don't risk for nothing.
Good luck with your consolidation!

[Sibirsky]

Pic at 184 cm:

https://imgur.com/a/QW4eW

I think I look proportional from this angle, but I'm not sure. My shorts end right in between my femurs and tibias on the knees

[YungGud]

Pic at 184 cm:

https://imgur.com/a/QW4eW

I think I look proportional from this angle, but I'm not sure. My shorts end right in between my femurs and tibias on the knees

From my sight,you look proportional

[YungGud]

How do you feel right now compared  to your pre-op conditions?

[Sibirsky]

How do you feel right now compared  to your pre-op conditions?

I feel great actually. I no longer get Morning stiffness on my ankles at all. My ankle muscles are about the same size as they were pre op but quads need a lot of work

[YungGud]

I feel great actually. I no longer get Morning stiffness on my ankles at all. My ankle muscles are about the same size as they were pre op but quads need a lot of work

That's great!congratulations
I was just scared if ur never gonna be the same as preLL conditions like crippled till the rest of your life but your experience show as that everything depends

[Sibirsky]

"it really that risky to target 8cm?"
Unlike most members here who feel the safe limit is a fixed number of cm i.e. 5cm, 6cm, my thoughts based on medical studies and consulting with orthopaedics are that the safe limit is defined by percentages. In short, less than 10% increase lengthening of an initial bone length is low risk, 10-20% is medium risk (minor complications like contractures, small ballerina) and more than 20% is high risk (severe ballerina, non-union). And in general, you risk screwing up proportions going over 20%

So for example, a person with an initial 40 cm tibia length can go up to 8 cm and be in the medium risk category (which is what I did. And since on average tibias are 0.8 of the length of femurs, one can safely assume you can push femur lengthening further

"I read your diary and it's quite amazing"
Thank you! I do try to keep it as interesting, consise yet informative as possible
"it seems to me that you spent very minimal time on everything (lengthening, consolidating and walking normally) and I'm still wondering how you accomplished all that with a really short time but good job on you brother!"
Thanks! Honestly, neither do I. My orthopaedic surgeon specialised in leg correction but not cosmetic limb lengthening. He allowed me to go up to 2.0 mm a day which was undoubtedly unsafe, but hey everything turned out fine.

However, going up to 2.0 mm a day is actually done but not for very long periods. Consolidation tends to be poor if lengthening is done this fast. But since I went for LATN and not externals, this is less of a problem

"my question since you did LATN is can you work out with weights while still having nails inside your legs?"
Yes. You need to have an orthopaedic surgeon in your home country with whom you can do X-Rays and consult with in order to determine to what degree your bones can handle weight bearing.

However, one must come to realise the intramedullary nail is not the same as internal lengthening rods. The former has been perfected over decades of development and is geared solely to provide support and allow early weight bearing not just for LATN but for many other non-cosmetic treatment like fractures. The latter is still relatively new technology and has to accommodate lengthening capabilities and support. Hence, the support capabilities of nails used in LATN is much better than that of internal lengthening nails. That's why weight bearing and walking, in some cases, can be achieved much faster in LATN than internal lengthening.


"I believe you also want to bulk up your legs as you said in your diary because I'm sure it's really skinny after LL, how soon can you do it? and isnt it dangerous?"
Again, that's why you need to keep seeing an orthopaedist in your home country to give you a definitive and medically-sound green light on what you can do and what you shouldn't. This and of course physiotherapy. In my case, immediately after nailing I was allowed todo leg presses and after I could walk( 2-months post nailing) pretty much I'm allowed anything even running except contact sports

It's a long journey, but I wish you then best in your future endeavours!

[doomsday]

Sibirsky have you got any xrays?

[Bron]

Sibirsky,

I have read it, thanks for your answers!

[Sibirsky]

Sibirsky have you got any xrays?

Yes I do but you need to be specific what kind of X-Rays you want. Too many for me to post at random so I prefer uploading based on request

[Sibirsky]

Sibirsky,

I have read it, thanks for your answers!

You're welcome! Glad to be of help

[Sibirsky]

Hey guys I have some X-rays you may be interested in. Here's my X-rays taken when I was having correction done just before nailing

https://imgur.com/a/IonoC

[Sibirsky]

....and here are X-rays taken post nailing. This angle should be able to reveal certain things you may want to consider.

https://imgur.com/a/Ablts

Firstly the nail is intentionally sticking out of the bone. This is to allow removal later on, though it makes kneeling uncomfortable at times but not downright painful. Secondly there are multiple screws that are keeping the nail in place. These nails are quite large and can actually be felt on the surface through the skin, but only the screw head not sharp pin part. They also don't hurt unless you hit them against something like a car dashboard (which I have several times). Then they'll hurt like a muthafuka 

Feel free to post questions and requests!

[doomsday]

good consolidation for tibias but yeah quite unusual for the nail to stick out. I guess it makes no difference  as long as you dont hit that sticking out part. Did you get any recent xray to see progressing consolidation ?

edit

The doc knew his stuff. You had the hexapod frame , the same used by Dr daghoon Lee.

[Sibirsky]

good consolidation for tibias but yeah quite unusual for the nail to stick out. I guess it makes no difference  as long as you dont hit that sticking out part. Did you get any recent xray to see progressing consolidation ?

edit

The doc knew his stuff. You had the hexapod frame , the same used by Dr daghoon Lee.

Yeah sure I'll try to post them because now I only have them in film and not digital. I'll try to get a digital copy of Incan

Yup it's true that he wasn't a cosmetic limb lengthening doctor, but he sure wasn't some quack either

[Sibirsky]

Hey guys just a short progress report. I realise I am now able to do squats for about like 10 times straight before feeling tired. Also I have regained that torque needs to initiate jogging but my muscle strength has yet to allow me to run or jog normally

Cheers!

[Sibirsky]

Message from a member:

"hey there sibirsky
how are you doing with your progress?"
-I'm doing fine  thanks!

"Im looking for some words of advice,...
from reading here and there on this forum, i gather that the more popular or reasonable way to lenghten (if youre into getting it done in 1 surgery), is to do Femur lengthening.
I know you chose to do tibia.

thus I have few questions in mind -
1- This may be totally misperception of mine, but i feel like femur lenghtening is actually more complicated, its a bone deeper within tissues of the leg. and biomechanically speaking, it feels to me as if a change of this portion of the leg (femur) makes much more of a mess to the funcion of walking, running etc. again, im no orthopedic surgeon nor that anatomy expert, but thats my impression.
-why did u choose to do tibia?"

-2 reasons: It's (WAY!)cheaper(or way less painful in the case of external femurs) and using externals allow correction. Choosing internal femurs may not allow to have precise correction because we'd need a hexapod for that. However I do understand that for the knee joints is better to do femurs if you need hugher lengthening  though I can't be absolutely sure about this. What i am absolutely sure about is that the ideal tibia:femur ratio is 0.8 and so for the best results one should measure ones legs via x-rays and only then see which limb would be the best to be lengthen so that there is the least deviation from this ratio. The tibias should best not exceed the size of the femurs post lengthening

"2- I just happen to see on Youtube a video of a kid underwent tibia lenghtening by dr. mahboubian, and his walking post op (few months) seems totally normal. to be honest that made me thrilled and totally made me rethink about tibia as an option..."

-Not to burst your bubble or anything but children's bones are very different from adults. Less weight bearing is needed and the bones are thinner and more malleable. Hence the time needed to wear ex-fix is much lesser. However it's not recommended kids use IM nail because it could injure  growth plates so there's that..

3- "whats your take about surgeons who dont do this ll as cosmetic surgery routinely?
and about the 'less advanced' techniqes regarding this operation and its advantages / disadvantages...."

-So firstly we must first understand what counts as a limb deformity? It could be angulation (bow legs/knock knees) it could be translation issues, but most importantly in our case, a deformity can be a limb length discreapancy where one leg is longer than the other. So by default surgeons who specialise in this field are adequately trained on how to lengthen limbs and equalise them. The should be well-trained in carrying out osteotomies . But what differs in cosmetic cases is the amount that a patient wants to lengthened (which is not fixed unlike deformity cases where the lengths need equalising) and the ethical dilemma of it: is it morally correct to break a perfectly healthy persons legs in order to solely bring about a cosmetic benefit, perfectly knowing athletically the patient may not reach pre-surgery levels of fitness?

So in essence I think that an orthopaedic surgeon that is qualified in the aforementioned types of deformity correction procedures can commit to the patient and accept the consequences from a moral standpoint, it should be fine

As for technology...I can't really comment too much. From what I understand generally, more advanced=more expensive=more comfort + faster recovery


"Hope for your speedy recovery"
-Thanks man! All the best to you too

[Mikayyy]

Hey, I was just wondering how long did it take you to walk on crutches after nailing? I heard it hurts a lot that you technically can be using them but they might cause damage until a certain time has passed. What was your experience with nailing like?

[Sibirsky]

Hey, I was just wondering how long did it take you to walk on crutches after nailing? I heard it hurts a lot that you technically can be using them but they might cause damage until a certain time has passed. What was your experience with nailing like?

1 month after nailing I started using a walker. About a week later I was strong enough for crutches and like about less than 3 weeks later  I was already walking without support. So yeah I progressed quickly.

Nailing is fine in my case so far. I mean it's been really well I honestly have no idea why anyone would prefer externals other than cost factors. But that's just my case; there might be some bad experiences with LATN so I can't guarantee a great outcome

[limby101]

hey
thanks for your sharing of your experience, its helpful.

about LATN vs LON:
you wrote ... "Discussed about benefits of LON( cheaper, 1 major surgery + 1 minor frame removal surgery, no corrections possible at all) vs LATN (more expensive, 2 major surgeries, correction can be done before nailing) Eventually I settled for LATN and the surgery was scheduled a week later.

From what ive read, I couldnt find an explanation for the LATN being superior (and hence why is it more expensive). Ive read (correct me if im wrong) that LON allows your consolidation time to be shorter. add this to making it a "1 major surgery" vs. 2 (LATN) , im trying to find the reason to choose LATN.
if its the corrections before nailing thing, well could u elaborate on that?  what and how the surgeon correct exactly? how often is correcting needed?  did u have any corrections before nailing?

Thanks!

[limby101]

and another thing, about the scars. do they bother you?
I suppose theyre not going away, but to what extent they will be fading out?