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[limby101]

Hey
I'm currently doing external fixator (hexapod) on one tibia, for deformity correction.
The doctor suggested nailing after the correction is done, instead of waiting for healing before removing the fixator.
I'm wondering about the pain levels of intramedullary nailing?
Would love to hear people experience.
I know it shortens time with fixator, but still it's another surgery, and I'm concerned about pain and recovery from this procedure.
Thanks

[Medium Drink Of Water]

I had LON tibia so I don't know what the fixator feels like without the internal.  But I had inflammation issues in my knees (and still do 15 years later, but much less severe) that was probably caused by the internals; the frames were 3 to 4 inches away from there.

If you can tolerate the fixator, I say don't use the nail.

[limby101]

Thanks.

My goal is not so high... 3, maybe 3.5cm
What is the minimal time possible before consolidation allows removal of frames?
LATN theoretically can be immediately after lengthening period which can be 2 months top... I'm afraid waiting this whole time with fixator would be too long for my sanity. ...

[Golden]

Thanks.

My goal is not so high... 3, maybe 3.5cm
What is the minimal time possible before consolidation allows removal of frames?
LATN theoretically can be immediately after lengthening period which can be 2 months top... I'm afraid waiting this whole time with fixator would be too long for my sanity. ...

Great, would you like to share some of your surgery? Did your doctor get rid of the deformity? are you doing tibias?
how long did it take you to reach 3-3.5 cm? for how long are you going to wear the fixator until the consolidation of the bones (NO LATN)?
also, who is your doctor if you don't mind?

I would like to say, don't use any nail as you are already half way.

[limby101]

I did tibias to lengthen and correct bowlegs.
My bowlegs was minimal and most people wouldn't do the surgery just for that.
The surgeon wanted to do both legs but with time gap of 2-3 weeks because its too traumatic to do both.
I was already prepared for doing both and actually was pissed to do one at a time. But after the surgery I realized it's much harder than I imagined. I'm almost 2 months after surgery and still can't put all weight on the leg. If I do, there is pain in fracture area. Other than that the first month was hell. My goal was 4-5 but I reduced it because I cant see myself going through all this long recovery time...twice(!).
So on hindsight maybe both legs would be better? That is of you can manage the pain and ok with being on wheelchair and dependent on others help all the time.
I was planning to do LATN and put the nail once I'm done lengthening but now I'm not so sure. It's another surgery with it's own risks....
For me, the challenge is mostly mental. Dealing with not being able to walk normally for a long time is hard. You should be seriously prepared for it and be highly motivated and optimistic. Sadly I'm not the type.
Gaining 3 cm is probably useless for most opinions here, but doing more than that would mean I have to be 6 months with the fixator and then having to do it all again.
Doing less might allow me to live with a minimal discrepancy for a while until I'm ready for the second leg and hopefully do it with precice.
The bowleg is like70 % corrected by now and I think I'm at 2.5 cm gain for now

[Golden]

I did tibias to lengthen and correct bowlegs.
My bowlegs was minimal and most people wouldn't do the surgery just for that.
The surgeon wanted to do both legs but with time gap of 2-3 weeks because its too traumatic to do both.
I was already prepared for doing both and actually was pissed to do one at a time. But after the surgery I realized it's much harder than I imagined. I'm almost 2 months after surgery and still can't put all weight on the leg. If I do, there is pain in fracture area. Other than that the first month was hell. My goal was 4-5 but I reduced it because I cant see myself going through all this long recovery time...twice(!).
So on hindsight maybe both legs would be better? That is of you can manage the pain and ok with being on wheelchair and dependent on others help all the time.
I was planning to do LATN and put the nail once I'm done lengthening but now I'm not so sure. It's another surgery with it's own risks....
For me, the challenge is mostly mental. Dealing with not being able to walk normally for a long time is hard. You should be seriously prepared for it and be highly motivated and optimistic. Sadly I'm not the type.
Gaining 3 cm is probably useless for most opinions here, but doing more than that would mean I have to be 6 months with the fixator and then having to do it all again.
Doing less might allow me to live with a minimal discrepancy for a while until I'm ready for the second leg and hopefully do it with precice.
The bowleg is like70 % corrected by now and I think I'm at 2.5 cm gain for now

I think you should have done both legs and correct them at the same, it's much better than waste time like you do now, even you still rely on others to help.

did you ask your doctor how long you would be on frames if you don't do LATN?
why it's only 70% of correction? is there any problem?

you said that you are almost 2 months after surgery and still not finished yet! how?

[limby101]

I'm 1.5 months after surgery, not finished lengthening phase yet because honestly I had breakdowns during this time, had days I stopped lengthening and other days I even turned things backwards because I decided to call everything off.
I know it's really bad and stupid but realizing my original plan of being with fixators for 3 months has turned to a year or so really put me down and scared me.
On the other hand, having frames on both legs is significantly more difficult than I expected.
I'm in a phase in my life and a mental state I just can't stay home and walk with crutches for such long time.

How long fixators without LATN - I think it would take about a month for each cm. Like for 3 cm it would take 4. And I guess after removal it would take more time until my walking is normal. And maybe 4 months don't sound so bad, but when you're handicapped and can't walk normally, everyday is like a year.

I'm actually still debating with myself if I want to go through or cancel everything.
This week I have a checkup and I will have do decide which route I take. If I'm close to 3cm now, and if the doctor gives me good prediction of time until removal, I might endure it. Otherwise I might try to call it off and cut my losses.

The take home message - be mentally prepared for a long time.

[Golden]

I'm 1.5 months after surgery, not finished lengthening phase yet because honestly I had breakdowns during this time, had days I stopped lengthening and other days I even turned things backwards because I decided to call everything off.
I know it's really bad and stupid but realizing my original plan of being with fixators for 3 months has turned to a year or so really put me down and scared me.
On the other hand, having frames on both legs is significantly more difficult than I expected.
I'm in a phase in my life and a mental state I just can't stay home and walk with crutches for such long time.

How long fixators without LATN - I think it would take about a month for each cm. Like for 3 cm it would take 4. And I guess after removal it would take more time until my walking is normal. And maybe 4 months don't sound so bad, but when you're handicapped and can't walk normally, everyday is like a year.

I'm actually still debating with myself if I want to go through or cancel everything.
This week I have a checkup and I will have do decide which route I take. If I'm close to 3cm now, and if the doctor gives me good prediction of time until removal, I might endure it. Otherwise I might try to call it off and cut my losses.

The take home message - be mentally prepared for a long time.

it's really frustrated, this isn't a walk in the park.

even for 4-5 months, it doesn't seem easy as many people think.

btw, who is your doctor? do you have any pain? how is your PT with those huge frames? how many millimeters do you do per day? how is your sleep?

did you get any infection so far?

[limby101]

I do not wish to disclose personal information.
I'm 37 from Europe.
The surgeon is not one of the celebrities...

Anyway, I'm at 3cm today.
I did 1mm per day BUT, it wasnt in a consistent rate, because I had days with pain which made me stop. If I make an average rate of lengthening during this whole time (1.8 months) I think it's about 0.6mm per day. 
Pain: pain was horrible at the first 2-3 weeks.  I can't really say if the pain was related to the lengthening, the trauma of surgery, or an infection I may have had.
Infection: one pin was looking bad immediately after surgery, two weeks after surgery I started iv antibiotics for two weeks, but the pin site still looked bad so I had a surgery to replace that pin. So of it was a pin site or pin tract infection, I guess ill never know.

Sleep was bad for the first month. Especially because it's very uncomfortable. It gets better though as the general pain decreases and you can sleep on the side etc.


PT: I do my own exercises, for tibia basically its dorsiflexion and knee straightening. I never got ballerina foot but I also didn't lengthen too much and at a slow rate overall...

[Golden]

I do not wish to disclose personal information.
I'm 37 from Europe.
The surgeon is not one of the celebrities...

Anyway, I'm at 3cm today.
I did 1mm per day BUT, it wasnt in a consistent rate, because I had days with pain which made me stop. If I make an average rate of lengthening during this whole time (1.8 months) I think it's about 0.6mm per day. 
Pain: pain was horrible at the first 2-3 weeks.  I can't really say if the pain was related to the lengthening, the trauma of surgery, or an infection I may have had.
Infection: one pin was looking bad immediately after surgery, two weeks after surgery I started iv antibiotics for two weeks, but the pin site still looked bad so I had a surgery to replace that pin. So of it was a pin site or pin tract infection, I guess ill never know.

Sleep was bad for the first month. Especially because it's very uncomfortable. It gets better though as the general pain decreases and you can sleep on the side etc.


PT: I do my own exercises, for tibia basically its dorsiflexion and knee straightening. I never got ballerina foot but I also didn't lengthen too much and at a slow rate overall...

what kind of external fixators did you get?

do you only have a deformity in one leg? why you are doing it for one leg only?