Hi guys,
I had surgery only 2 months ago. I chose tibial lengthening with the LON method. I only wanted 5cm, so it seemed to be a fairly safe option with the internal nail supposedly preventing misalignment. I have just finished lengthening around 5 cm and had my tibias x-rayed (see below). Anyway, as you can see in the x-rays the cut of the left tibia was very poor and left me with very little posterior bone above the cut. On the right tibia, the cut was a little bit better but left me with a posterior fracture where the yellow arrow is. As a consequence, it seems that there is not enough strong posterior bone on either leg to guide the upper part of the tibia along the nail. I suppose, due to the tightness of muscles, ligaments, and lack of bone to force the tibia above the cut to stay in alignment with the nail, it has become misaligned with the tibia below the cut by about 10 degrees on both legs (the angle should be about 90 degrees, I assume). As a side-note, the misalignment is also clearly visible from the outside as big hard bumps in the skin (no pics, sorry). Also, the knees are sore all the time, especially the left knee. I think this has to do with how the external fixators were positioned on my legs. It is as if the angle between where the fixator is attached to my ankle and where it is attached to my knee is wrong. Especially on the left leg, it seems as if it hinders me to fully extend the leg.
x-rays:
https://imgur.com/sP3Rl3Shttps://imgur.com/bS4g1C0I don't understand how this could happen. The doctor told me before surgery, that I have very good and strong bones, so it must be that he did not apply enough force to break the tibias cleanly. Also, I think he cut the bone too high. What is the point of having an internal nail to avoid misalignment, when there is not enough bone around the nail to force the tibia in alignment? Of all the complications, I contemplated before surgery, this never ever crossed my mind, and I cannot seem to find something similar on this forum. I will not write the doctors name here at this point, because I am dependent on his care, and I am not sure he approves. I hope you understand.
Unbelievably, the doctor has told me that I do not need to worry, as the new bone will magically correct the align by itself. But I am not sure what he means by that. Sure new bone will connect the parts somehow. But I highly doubt that it can bring down the angle from 10 to 0 degrees because it seems that this would require some serious force to overcome the opposing forces that facilitated the misalignment in the first place. I am deeply worried that if this will heal with the 10-degree misalignment, as I cannot stand straight. After consulting with an orthopedist that is not a LL specialist, he expressed the same concern and said if the misalignment is not reversed, I will not be able to extend my lower leg fully and will, therefore, have a permanent slight bend in my knees. Also, I suppose, having a misalignment will lead to stress on joints and back because of improper load bearing?
Has anyone had a similar problem? What can be done to resolve this? How much time do I have to fix this before it consolidates with misalignment? I would really appreciate if the community would give me some solid advice that I can bring up when I talk to the doctor next week.
Author
Topic: How fked am I? What to do about tibial misalignment? (Read 9186 times)