Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[Deepak Chopra]

This is why I dont do lengthening in India. I am Indian but I will still do lengthening with Paley. With Paley there is no way you will be having frames for one year. I think Parihar probably messed up in surgery to make your bone take so long to heal.

[YellowSpike]

This is why I dont do lengthening in India. I am Indian but I will still do lengthening with Paley. With Paley there is no way you will be having frames for one year. I think Parihar probably messed up in surgery to make your bone take so long to heal.

I don't think Kilo's doctor messed up...tibias just take a LONG time to heal man.

[Alittletooshort]

Dr. Parihar didn't mess anything, this is just the timeframe it takes for everything to heal up.
I think Kilo's diary is acutally a very succsessful one.

[crimsontide]

you will definitely not be in frames a long time if u go to paley... because he doesnt even do externals


ll takes a long time to recover from... my ankles feel normal now just for the last week, and this was about 12.5 months after surgery

[Deepak Chopra]

I don't think Kilo's doctor messed up...tibias just take a LONG time to heal man.

Dr. Parihar didn't mess anything, this is just the timeframe it takes for everything to heal up.
I think Kilo's diary is acutally a very succsessful one.

you will definitely not be in frames a long time if u go to paley... because he doesnt even do externals


ll takes a long time to recover from... my ankles feel normal now just for the last week, and this was about 12.5 months after surgery

One full year time is crazy even for externals. So many leg lengthening info says 1 month per centimeter and maybe 1.5 months per centimeter to be safe. So that makes me think Parihar did something to mess up bone healing because otherwise it wouldn't be like this.

Crimson, I know you are taking long too but you had complications with your doctors and did extra surgeries. Kilo didn't have extra surgeries to fix things and it is still taking forever. This is why people say don't go india.

[crimsontide]

im doing ok actually

and most people take over a year... not just in india... the person i mentioned that wasnt  ok  for 15 months went to russia

i do have to fix left leg  which sux, but  ankles,etc are fine now

kilokahn will get there too

i dont disagree about india though. id avoid it.  its possible dr parihar is being too conservative... 12 months in a frame is really going to prolong recovery

i know that me eing in a cast for 9 weeks prolonged mine... took me months to get back to normal... after a year in frames, the recovery time is gonna be insane.... it'll happen though

[KiloKAHN]

One full year time is crazy even for externals. So many leg lengthening info says 1 month per centimeter and maybe 1.5 months per centimeter to be safe. So that makes me think Parihar did something to mess up bone healing because otherwise it wouldn't be like this.

The reason Dr Parihar is on the conservative end for frame removal is because he says it minimizes the incidents of post-op complications that happen with early fixator removal, such as re-fracturing of the bone or bending of the new regenerate. He's been a specialist in Ilizarov surgeries for 24 years, so his recommendation is likely spot on. He's not the only doctor with this philosophy. According to TRS, both Dr Rozbruch and Dr Birkholtz recommend wearing the frames for 2 months per cm lengthened, and for 6 cm lengthening like I've done that would equal 12 months of frame time.

With Paley there is no way you will be having frames for one year. I think Parihar probably messed up in surgery to make your bone take so long to heal.

If Dr Paley was still offering external fixation for cosmetic cases, he'd probably recommend the same as Dr Parihar. Here's the excerpt about external fixation from Dr Paley's website:

External Fixation Alone
When only an external fixator is used, the fixator needs to remain in place for both the distraction and consolidation phases. If the fixator were removed at the end of the distraction phase, the new bone would collapse and reshorten. Therefore, the external fixator needs to remain in place until the regenerated bone appears solid enough on the radiographs (x-rays). At that point, the device can be removed. Often, a cast is applied to temporarily protect the bone from breakage for an additional short time. The total time in the external fixator can be estimated to be approximately 1 month for each centimeter lengthened in children and 1.5 to 2 months or longer per centimeter in adults.

http://limblengtheningdoc.org/limb_lengthening_intro.html

[theuprising]

Hey Kilo has there been any mention of you needing to have a release surgery?

From the diaries I have read it seems to come up often when people go over 7 cm on tibia,
how are you fairing?

[crimsontide]

i just read an article that a member here posted about ballerina in tibial lengthening


im convinced now regarding achilles release


mine is fnally almost healed and i definitely would not be doing well with my ankles now if i hadnt have gotten a surgery


ballerina is by far the worst complication of tibial lengthening.... excluding non union

[KiloKAHN]

Hey Kilo has there been any mention of you needing to have a release surgery?

From the diaries I have read it seems to come up often when people go over 7 cm on tibia,
how are you fairing?

I'm able to walk with feet neutral after a couple minutes of walking. The wires near the ankles give me a sharp pain when I walk at times and it prevents me from pushing myself with stretching as much as I'd like to. I think I'll be able to get my dorsiflexion to 20 degrees eventually once I get these frames off. The local orthopedist seems to think so anyway. Dr Parihar doesn't think I need a release also. His tibia lengthening limit is generally 6 cm so I think that's why he rarely needs to do them for equinus treatment.

[KiloKAHN]

Update: 5/8/2015
I'm walking around twice as fast as I was in that walking video I posted. I've been focusing on trying to get my balance back. Tried walking with crutches again and fell about four times. I seriously hate these things and have no idea how anybody manages to walk with them while having frames on both legs. Went back to using the walker which I like a lot better. I put it in front of me and try to stand as straight as possible while taking steps forward with all my weight on one leg while the other is in the air before stepping down. I really stretch out the calves this way, but on one step I felt a huge stretch on my left leg by the ankle and around an hour after that my ankle started swelling badly.

It's been a day and a half now and the pain has only become worse. If I lightly brush my foot across the floor I get heavy pain on the lower sides of the left leg as well as in the Achilles tendona area. Hoping it goes away soon but I stayed in the wheelchair all day today because even standing hurts now. I have my next appointment on the 19th. There should be more progress with the bone healing.  Really want to get these frames off come end of June.

[crimsontide]

the achilles area just takes time... a long time


im guessing when you walk that your achilles starts to feel incredibly tight?

i would just rest until  the area feels okay. i think the achilles tightness is very common. it sucks , but i think the only way it goes away is with time and walking

[KrP1]

Hey crimsontide. At how many cm of lenthening  do you think achiles lengthening could be necesary for most people? Around 5/6?

[crimsontide]

it depends really


i think kilo and i have the worst combination for lengthening, which is stocky legs with big tight calves

Even with out surgery, achilles area always feels tight for a while. just look at the diaries. everyone that does tibias complains about a tight achilles when walking.  takes a while to go away. for people like swden, it never seems to go away

[KrP1]

I think that sweden would be in a better condition if he have done achiles lenghtneing

[crimsontide]

yes, i agree

it takes a while to recover from, which is the biggest negative to achilles surgery, but    if he would have had it a year or more ago, he'd be much better now

[lumiere]

Quick question: did you have the Achilles Tendon lengthening surgery? If not, how would you prevent ballerina foot? I'm now at about 4 cm of lengthening, I'm going probably for 6.5 or 7 cm, and I'd really like to avoid such surgery..

Lumiere

[Moubgf]

Seems that internal femurs are way better surgery to take on. Less compliactions and more aestethic than long tibias.


What is the best doctor for itnernal femurs and what is the cost Thanks !!! XO

[KiloKAHN]

the achilles area just takes time... a long time


im guessing when you walk that your achilles starts to feel incredibly tight?

i would just rest until  the area feels okay. i think the achilles tightness is very common. it sucks , but i think the only way it goes away is with time and walking

The tightness is still there, but it's gotten better. The main issue I have now from the sprain is that I get very sore near the left ankle joint on my left leg. If I touch it it feels like I have a bad bruise.

Quick question: did you have the Achilles Tendon lengthening surgery? If not, how would you prevent ballerina foot? I'm now at about 4 cm of lengthening, I'm going probably for 6.5 or 7 cm, and I'd really like to avoid such surgery..

Lumiere

My surgeon told me he didn't think achilles lengthening was necessary and that over time with stretching I'd be okay. He doesn't really like to perform achilles lengthening unless he finds it absolutely necessary. His lengthening limit is 6 cm so that's probably why he doesn't have to do it as much. If I did 7 cm I feel like I probably would have needed it.

Best thing to do is constantly do your ankle stretching exercises and stand as much as you can. Wear your straps to keep your feet neutral as much as you can, too. You might end up with equinus anyway though and if it's severe enough your doctor might recommend the tendon lengthening anyway. He does that for a lot of his lengthening patients, right?

[theuprising]

Seems that internal femurs are way better surgery to take on. Less compliactions and more aestethic than long tibias.


What is the best doctor for itnernal femurs and what is the cost Thanks !!! XO

How is this troll still on the forum?

[maximize]

Keep up the good work. You're well on your way. Hope everything feels great once those frames come off.

[Boxer4748]

 Hopefully will see pics of you after frame removal and have a nice time bro ....

[KiloKAHN]

Update: 5/19/2015
Went to the ortho today and for the first time used my walker to get around the building instead of my wheelchair, so everyone was a bit surprised to see me standing up. I took x-rays and waited a bit for my ortho, who showed me what the x-rays looked like and revealed that my left fibula is finally fully connected. The consolidation looks good on the left leg and he said he'd even be confident removing the frame now. The right leg has good consolidation on the tibia, but on the fibula he said it doesn't look like it will consolidate fully. The regenerate was really good up to a certain point, but then the regenerate narrowed and it looks like it will only connect at a very narrow point, kind of like the narrow middle portion of an hourglass. He said it's not a big deal though because the fibula isn't responsible for the weight bearing.

He's interested in doing a two-stage frame removal and thinks I should see him at the end of June to get my left frame removed and then keep the right frame on for another month or so before I go back to him to remove that one. I need to see what my co-pay for surgery will be though, because if it's really pricey then he's just going to remove them both at the same time when he feels the right leg is ready.

His assistants removed all my dressings and we saw that on some of my pinsites I have granulation tissue forming. They look like blood pockets. He was also concerned about the amount of drainage coming out of the pinsites on both legs, so he took a sample from each leg and he's going to have them tested to make sure I don't have any antibiotic-resistant bacteria. He's concerned about me getting a bone infection later so he prescribed me a really strong antibiotic that I'm going to pick up tomorrow.

Right now my frame removal surgery is tentatively scheduled for June 29.

[Sean Connery]

Dude screw a two stage removal. Just do one surgery to get it both removed and you will get it over with. Might as well just leave the left one on a little longer until the right one catches up.

[theuprising]

Hey Kilo is there any reasons as to why your fibula won't fully consolidate?
What was your rate of lengthening btw.

[KiloKAHN]

Hey Kilo is there any reasons as to why your fibula won't fully consolidate?
What was your rate of lengthening btw.

Not that we know of. My regenerate on the right fibula was looking really good up until recently, maybe like the last month or so, and from that point on the regenerate started thinning out and getting narrow in the center. I'm told it's not really an issue as the fibula is only responsible for weight bearing, although it does have a role in stability. The only thing it will affect is that my ortho wants to be a little more cautious about removing the frame.

My rate was .75 mm throughout distraction except for a week where I alternated between .75 and 1 mm every other day. But the regenerate was normal throughout my entire lengthening phase and this narrowing happened during consolidation.

[theuprising]

I assume no major changes in activity or diet in the past month.

What did Parihar have to say about it? Has he seen it happen before?

I have heard that fibula is often used for bone grafts so it is not a major
issue if it doesn't consolidate but obviously it's something you would
prefer to rather than not.

[KiloKAHN]

Latest X-Rays (5-15-2015)


So as a reminder of what I updated earlier, when my local orthopedic surgeon went over the x-rays with me, he told me that he thinks I'm going to have incomplete consolidation of my right fibula. He said he doesn't think it's a big deal because the fibula isn't responsible for weight bearing, but because of how the consolidation is going he said he wants to do a two-stage removal of the frames. He said he thinks the left frame should be removed on June 29th and then he wants to wait a little longer to remove the right one.  I was also told that he would be uncomfortable leaving the frames on too much longer because he said the more my pin sites open up the larger my chances are of getting a bone infection.

Turned out I don't have any antibiotic-resistant bug. Just had mild staph infection that should be treated with the antibiotics he gave me (clindamycin).

Radiologist left some notes on my x-rays this time and said I have periarticular osteopenia at the ankles (there are other x-rays of the lower leg which show my ankles) and knees bilaterally.

I sent my x-rays to Dr Parihar with my concerns and await his reply.

[crimsontide]

wish you the best kilo

I'd be concerned about ankles, but this is the risk we take

Your leg though looks a bit crooked to me?? the second x ray from the left. i might be wrong though

Eventually, even if it takes a year more, you'll be okay. this surgery seems to never go according to plan

[KiloKAHN]

I was told that the curvature just looks more than it is because my tibias were naturally curved and elongating the gap just makes it look more pronounced. On all my radiology reports they say that the alignment is normal and Parihar and the local ortho haven't said anything about it being off. So I'm guessing that aspect is okay. I've been taking this supplement called Bone Up since just after my last x ray to try to help with the bones. Hope it works.

[maximize]

Radiologist left some notes on my x-rays this time and said I have periarticular osteopenia at the ankles (there are other x-rays of the lower leg which show my ankles) and knees bilaterally.

That's too bad about the incomplete consolidation of the fibula. I wonder if it will consolidate further once the frames are off. Even if it doesn't affect weight bearing, obviously it would be preferable if it consolidates.

As for the osteopenia, I wouldn't worry even in the slightest. Just don't go playing any rugby right now. Your bone mineral density will improve rapidly once the frames are off and you are full weight bearing. As a young otherwise healthy guy, your bone mineral density should bounce to original levels within at most a year or two. It shouldn't affect your day to day function in any way in the interim.