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[LLprime3]

A few new insights about the condition called femoral anteversion:

You can look at the whole range of hip motion, which allows to rotate your femurs inside and outside, as a spectrum of rotation distributation.

100% femur rotation is equally distributed so that a normal person can rotate his femur inside by 45° and outside by 45°.
It seems that in my case I can rotate my femurs by 60 degrees inside and 30 degrees outside, AFTER I fully heal.

For a normal walk a person needs to rotate his femurs approx 15 degrees outside.
But right now I can rotate my femurs just barely 15 outside. A few days ago I could only rotate my femurs about 5 degrees outside, which is why it felt like I didn't even have the capacity to roate my femurs enough to walk normally.

What restricts femoral outside rotation is also the achilles tendon
The doc explained how he treats children who suffer from cerebral palsy. They also have an inside walk with their femurs rotated inside.
"Equinus deformity is a common finding in children with cerebral palsy and may be treated by Achilles tendon lengthening."
What the doctor wanted to tell me with that is that I will regain a fair amount of outside rotation back, so that walking normally will not feel like I have to rotate my femurs 100% (15 degrees) but it will feel like I only require 50% outside femur roation (15 out of 30 degrees).

Basically at the end of the recovery I will be able to rotate my femurs 60° to the inside and 30° to the outside, and I will walk as comfortably as I did with my bow legs. Receiving a surgery to adjust and distribute the rotation equally (45° and 45°) will be optional, but not necessary.
That is one reason they did not perform any rotation surgery on my femurs. Because it will not even be necessary after I recover my achilles tendon flexibility fully and regain the remaining outside rotation which is within my capacity.

If I would receive a femoral rotation surgery based on what I feel I need, I would over-correct my femurs and rotate it too much as of right now.

The second reason they did not perform the rotation on my femurs is also because they don't perform it in general, which is fair enough to say.

So they knew better than me that I will be alright, but didn't explain it to me to the extend I needed to know. Or you could say they did over and over try to explain it to me, but I didn't understand two things:
The achilles tendon enables femoral outside roation AND I need femoral outside roation to walk normally and even more outside roation to walk normally without it feeling like effort.

Now that everything has been said and exchanged, I have nothing negative left to say about this team.

Here is a summary about pro and cons:

+ no bone related pain after walking up from the surgery
+ higher reliability due to having more than one surgeon perform the surgery
+ compared to my previous femur surgery, I received more extras, such as
free scar revision of actualy bad scars, free wheel chair, meals in this hotel are included in the price, the physical therapist wears gloves during bandage change (yes, I did not have that with the previous doc...), more medical equip to take home with to treat my scars
+ in hindsight up to today no errors have been performed on my legs, I want to make this clear because the last posts could leave a bad taste

- communication and misunderstandings
- hospital experience

[LLprime3]

Hi, it's been 9 months since my surgery.

I faced several different complications after my last surgery (frame removal + nail fixation)

1. A fracture on the left leg between ankle and lower fixation screws:
https://i.imgur.com/BbplMA1.png

It took 10 weeks to heal and I could not walk to increase recovery

2. Nerve damage on the right knee, lower end towards the inside. It took about 6 weeks to disappear. I could not walk a certain way because of it. It hurt more than an injury.

3. Another nerve pain along the right side of my leg. The nerve going from right hip, down to right side of the knee and further down the right ankle.
That pain hurt on two spots, the right side of my knee and around the ankle when my right foot had to support my weight while leaning forward and pressing down with the front end of my foot. Also took around 6 months to go away. I went away after I forced myself to walk despite the pain.

So basically, after my 2nd surgery to fix the nail, I faced those three issues that cost me about 6 months of normal progress and walking.

I also have to deal with femoral anteversion. I can rotate both of my upper legs to the inside by 90° and 80° on each leg as opposed to 40° and 40° for normal people. The health insurance will cover the operation to fix this next year, since this is a big rotational deformity.

----
The bones that needed to heal after my 2nd surgery were:
- both femur heads without gap (to correct my mechanical axis)
- tibias with 5 cm gap each
- fibula, each with a gap
- the fracture without a gap on my left leg

Out of all those my femurs have properly healed, the tibias are showing promising signs of healing, but the shape looks weird.
My left fibula is healing nicely, my right fibula has developed non-union.

2022 07 13
https://i.imgur.com/3ZRCdzv.png

2022 12 13
https://i.imgur.com/w3ev6PX.png

I was walking okay for a few weeks.
Now it hurts on the right leg at the lower right fixation screw. I hope the bone is not cracked.

Right now I'm wondering if my right fibula is not consolidating for good, or is it delayed because my whole healing process was delayed by all those complications and I had to heal 7 broken spots instead of only 4.

[Ascender]

I don't think that fibula will consolidate without intervention such as bone grafting, there is a no callus formation there.

Also, what do you think caused the complications? Was it the fault of the surgeons?

[Limbfan2020]

@LLprime3

The fibula is not fixed with an additional screw. This will cause serious arthritis in 5+ years.

[LLprime3]

I don't think that fibula will consolidate without intervention such as bone grafting, there is a no callus formation there.

Also, what do you think caused the complications? Was it the fault of the surgeons?

The nerve damage? I did lengthen 13 cm in two surgeries. That alone might be enough of a reason.
And the non-union on the fibula. Same doctor, different legs. I'm not sure how only one part can have non-union myself.

[LLprime3]

@LLprime3

The fibula is not fixed with an additional screw. This will cause serious arthritis in 5+ years.

I have checked multiple diaries, asked people, and a local doctor.
It's split 50 50. The opinions and the actual x-rays.
Logically thinking it's not a weight bearing bone, so I don't know. If even not all doctors agree on this, why would your opinion be 100% correct, don't you think?

[Limbfan2020]

I have checked multiple diaries, asked people, and a local doctor.
It's split 50 50. The opinions and the actual x-rays.
Logically thinking it's not a weight bearing bone, so I don't know. If even not all doctors agree on this, why would your opinion be 100% correct, don't you think?

Since the fibula bone was invented by nature, it has an important function which is to stabilize the ankle joint. If it's not fixed with an additional screw it moves upwards resulting in a destabilization of the joint.

[shortisnotfun]

Thank you for a very in depth post. I believe I have the same issue with you regarding femoral anteversion. How you are doing nowadays?

[sphenopetroclival]

If you have recent imaging data please put it at this thread. Redact any information that could be used to dox you.