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[Whimsical]

Hi guys I was reading Jamal's diaries and at least 2 guys got non union. Then I read Unicorn's diary and she said she participates in a non union whatsapp group. They told me many patients suffer from non union. How big are non union chances when you get LL and can you prevent it?

[LongueEpopée]

from what i remember the younger you are, the lower the chances of non union are (best is under 25), and if you're a woman or from east Asia your bones heal not as good as men and european. Maybe someone can give a better explanation

[MirinHeight]

its actually pretty rare to get a nonunion if the osteotomy cut is very good and you dont lengthen fast.

[Whimsical]

In Dr Jamal's case do you think his technique is bad? Or the fact that his patients lengthen very fast?
Guichet's technique seems good but he advised Unicorn to lengthen fast. 2 mm per day. In her case that's the reason.
What about Monegal and Betz's cases? Bad technique?

[Body Builder]

Non union for someone who lengthens less than 1mm on femurs and less than 0.75mm on tibias per day, does not smoke and is not too old is really rare.
You face much greater risks with LL than that.

[7231]

Non union for someone who lengthens less than 1mm on femurs and less than 0.75mm on tibias per day, does not smoke and is not too old is really rare.
You face much greater risks with LL than that.

Is the chance of non-union higher for tibia than femur or is it same?

[MirinHeight]

Is the chance of non-union higher for tibia than femur or is it same?

the femur bone generally heals better than the tibia bone. so non union should be lower in femur

however, if you go to a bad surgeon, he/she can destroy the blood supply needed for healing when doing osteotomy break of the femur bone, which will lead to a nonunion. This is why Guichet is a butcher. you should watch how he does his osteotomies

[7231]

the femur bone generally heals better than the tibia bone. so non union should be lower in femur

however, if you go to a bad surgeon, he/she can destroy the blood supply needed for healing when doing osteotomy break of the femur bone, which will lead to a nonunion. This is why Guichet is a butcher. you should watch how he does his osteotomies

ok, thanks

[Whimsical]

I guessed that happened to Unicorn but in her case the 2 mm rate also affected the result. What about Jamal, Betz and Monegal? Bad technique too?

[MirinHeight]

I guessed that happened to Unicorn but in her case the 2 mm rate also affected the result. What about Jamal, Betz and Monegal? Bad technique too?

I don't like monegal. don't know about other two.

if you go to one of these six, you should be good:

paley, rozbruch,mahboubian, parihar, birkholtz, pilli

mahboubian is controversial due to how he promotes cll, but he's a good surgeon. however if you can afford mahboubian, you should go to paley or rozbruch instead

[7231]

I don't like monegal. don't know about other two.

if you go to one of these six, you should be good:

paley, rozbruch,mahboubian, parihar, birkholtz, pilli

mahboubian is controversial due to how he promotes cll, but he's a good surgeon. however if you can afford mahboubian, you should go to paley or rozbruch instead

Do you have the contact/email id of Dr. Mahboubian? thanks.

[notatroll]

In my opinion Monegal's osteotomies have caused some Monegal patients to develop non union. There is Cooper's case in tibia (read his diary) and other femur patients in and out of this forum. They needed extra surgery. Non union is a dangerous complication.

[notatroll]

proofs by Cooper

Update:
I had very bad experience with Tibia lengthening. I made terrible mistake of doing tibia with Monegal. I probably went through worst ultimate nightmares. I usually write Dr. in front of him but he lost that honorary title long time ago. Ever since I came to US I had some nuisances about right tibia. It felt something did not go well. But I was giving benefit of doubt. I have been telling all LLers’ through private chat tibia should be easy and since this is one leg I should have much better experience than femur.

Late last year I went to see Dr. Rozbruch in New York to check on tibia. Immediately after reading x-ray he pointed out 3 major issues. 1) Provactum tibia bone curving 2) Fibula migrated up. When the monegal fixate tibia and fib bones he somehow pushed the fibula up and fixate. The angulation is not correct this is major issue out of three 3) low callous and possible non-union 4) lost nerve on feet about 25% (not major but had to fix).  Dr. R advised to fixed all three and his assistant wrote a note which I forwarded monegal right away. I asked precisely to Dr. R what can be done with him. The answer was reverse everything and put external fixator for tibia and small monorail for tibia and lengthen. I was devastated to hear that!

I emailed monegal and hoped he can correct the issue. But he denied any of that need fix. Similar response to Crimson: ‘everything is fine' and keep lengthening to your desire 5.5cm. He also advised me not see any LL specialist. I told him ok. But I was not stupid. I knew by then I have major issues and I was only about 3.5cm. I keep lengthening and start looking for a solution to fix right leg and lengthen left leg. I was determined to get it done in US because I cannot take more chances.
The two US doctor I communicated:
1) Paley : first chastised me for going for inexperience doctor second the complication is major and will require more time and money to fix. His recommendation is take out the fitbone, put external fixator to not to loose the distraction gained, inserted non lengthening rod, lengthen fibula by 1cm, plated fibula, fixated tibia/fibula, bone grafted tibia and fibula for non-union, nerve decompression and put new non lengthening rod. He estimated about $100K for fix and left leg lengthening with precise.
2) Rozbruch: fist he did not want to help and asked me to go my first surgeon. I told him monegal is not capable of fixing and cannot be trusted. He said he will help. Cost about the same.

I also contacted few other doctors and everyone agreed on the three issues.

I picked one of the US doctor and currently in recovering. I am not disclosing anything yet and will let you know eventually.


Monegal Issues:
1)   Dishonest: He did not disclose all the information and lied on patient count and his experience. He emailed he performed 600 bone segments. Come to find out I was third tibia patient. One of his patient told me in Spain everyone lies. His manipulates deliberately and black mailed his patient to write good things about him and defend him as often as necessary. You cannot trust this doctor and his patient specially from Spain!!!
2)   Unethical: If you are not honest than you do not have ethics. Especially in this profession you want to go to doctor who respects patient rights, if something is not right than let the patient know and possible solution to fix. Just not to say everything will be ok. You need more time.
3)   Poor Osteotomy: Most of his patient has issue with callous formation. Interesting part is all of the patient with few exceptions are lengthening less than 6cm. Still have poor bone formation. I have both fibula and tibia non-union and misalignment. Grafted both and I gained only 5.3com. I thought I did 6 but the x-ray show 5.3com.
4)   Poor logistics: When I had my surgery I was in recovery room for long time. He could not find me and went home without meeting me in person. He later phoned me to say everything went ok. They forgot to put catheter and I did not pee for long time. I screamed and used profanity to get attention at the hospital. The epidural was not turned on and I was in pain for long time. Nursed blamed me tempering with epidural and told monegal I shut it off.
5)   Pain management: I was in 10/10 pain level during first night. The worst pain of my life. Nurses and caretaker does not know how to manage pain. Their respond will be ‘that is normal’. On my last two surgery my pain level never went more than 2/3.
6)   Fibula bone: For monegal fibula bone is not important and ok to have non-union. Even mentioned he can take fibula bone put some place else for bone lengthening while I was in Spain. Fibula is sort of extra bone put in reserve. Such a stupid comment coming from surgeon. His action is not to do anything regarding my fibula non-union.
7)   Forum: He is using forum to fish new patient and anyone raised flag he tries to shut him off either by himself or through his patient. He gets mad to his patient if anyone writes bad thing and continuously monitor forum thread. He probably spends more time in forum than any of us out here.
   His Patients: most of his patients are good people by heart. We all come from same height neurosis industry and wanting to get taller. I feel forum is fraternity to support each other. This doctor is exploiting forum to his advantage. We need to stop him. I am still in contact with few of them. They need him to fix the issue, correct whatever complication and have to oblige whatever he asks them to write. I would not be surprised if few of his patients come to this thread and try to defend him.
9)   Complication: Almost all of his patient has some complications. Many of them cannot walk without crutches. Complications includes but not limited to premature fitbone fracture, fitbone malfunctions, loose screws, serious nerve issue, misalignment and unkown. Unknown are other complications which patient does not know because they have not seen other LL specialist.

Suggestion to Forum Moderator:

Ban monegal effective immediately and stop any patient going to him wherever possible. If I can save one life, leg or limb than I feel my diary has serve good for this community. Why let dishonest/crook surgeon come to forum and exploit the harmony of forum and most importantly destroyed people lives. I intentionally write ‘lives’ because it is not only one patient it’s the entire family involve.

Other patients prefer privacy atm.

[Dr Jamal A Nemer]

Eat well, exercise, walk with crutches/put weight on your broken bones (providing your nail is weight bearing of course) and you should be in union.