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Author Topic: Is this misalignment? How do I do now?  (Read 1943 times)

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dragonslayer

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Is this misalignment? How do I do now?
« on: July 02, 2023, 06:39:15 AM »

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Maison

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Re: Is this misalignment? How do I do now?
« Reply #1 on: July 02, 2023, 06:51:25 AM »





Don't why images not shown. links:

https://imgur.com/a/Dzv9ktO

https://imgur.com/a/vhzc6Yy

The left side looks like it could be procurvatum deformity.
Please provide picture of the entire tibia.
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DanishViking

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Re: Is this misalignment? How do I do now?
« Reply #2 on: July 02, 2023, 12:41:54 PM »

Why did you do tibia??
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Medium Drink Of Water

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Re: Is this misalignment? How do I do now?
« Reply #3 on: July 02, 2023, 03:42:19 PM »

Doesn't look like it to me.  If you can envision how the bone will heal straight after some minor remodeling, then it's probably not misalignment.  Ask a doc for confirmation though.
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shortisnotfun

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Re: Is this misalignment? How do I do now?
« Reply #4 on: November 21, 2023, 08:44:31 AM »

That is complete misalignment. You have procurvatum/flexion deformity.
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limby101

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Re: Is this misalignment? How do I do now?
« Reply #5 on: November 21, 2023, 12:26:24 PM »

I don't see any issue here. There's a callus in posterior aspect as expected.
Your knees are bend for taking the image only right?
Or can't you straight the knee at all?
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shortisnotfun

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Re: Is this misalignment? How do I do now?
« Reply #6 on: November 24, 2023, 09:11:58 AM »

I don't see any issue here. There's a callus in posterior aspect as expected.
Your knees are bend for taking the image only right?
Or can't you straight the knee at all?

You don’t see any issue because you think nail inside bone = good and don’t have much experience. This patient has procurvatum which is very visible.
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Hobbit99

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Re: Is this misalignment? How do I do now?
« Reply #7 on: November 26, 2023, 06:28:19 PM »

Looks like procurvatum
I also have this, but can be fixed easily with the external frame. I think in your case you need to remove the nail with another surgery, ask your doctor.
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limby101

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Re: Is this misalignment? How do I do now?
« Reply #8 on: November 26, 2023, 07:44:59 PM »

I'm not so sure about your diagnosis.
Look for normal lateral x-ray of tibia and see that there's a natural curvature of the proximal tibia towards anterior aspect.
Im not so sure this image is that abnormal.
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Mondlicht

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Re: Is this misalignment? How do I do now?
« Reply #9 on: November 26, 2023, 08:19:53 PM »

How can this happen? Bad surgeon? Bone alignment should be good with precise2. How to prevent this?
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NailedLegs

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Re: Is this misalignment? How do I do now?
« Reply #10 on: November 27, 2023, 01:41:55 AM »

How can this happen? Bad surgeon? Bone alignment should be good with precise2. How to prevent this?

Could it be a combination of not using a properly sized nail and creating the osteotomy too high?

I am not a Doctor so I cannot say definitely. What do you think?
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Maison

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Re: Is this misalignment? How do I do now?
« Reply #11 on: November 27, 2023, 06:17:46 AM »

How can this happen? Bad surgeon? Bone alignment should be good with precise2. How to prevent this?

Inserting blocking screw behind the nail can prevent this type of deformity.
Doctors like Rozbruch have written literature on this.
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shortisnotfun

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Re: Is this misalignment? How do I do now?
« Reply #12 on: December 02, 2023, 05:12:45 AM »

I'm not so sure about your diagnosis.
Look for normal lateral x-ray of tibia and see that there's a natural curvature of the proximal tibia towards anterior aspect.
Im not so sure this image is that abnormal.


The top segment and the bottom segment of the tibia must align straight. If you see the x rays, they are not aligned at the endpoints.
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CLLvet

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Re: Is this misalignment? How do I do now?
« Reply #13 on: December 18, 2023, 03:36:09 PM »

It is the blocking screws (free screws behind the nails) that ensure correct alignment without procurvatum. In your case, you don't have a huge problem with procurvatum (it is faily mild).

I am attaching my recent tibia x-rays to illustrate the concept of the blocking screw (please see the Imgur link to my x-rays below).

To give you idea of my timeline, I lengthened my tibias 6.2 cm with TSF External frames. Upon completion of lengthening, my surgeon removed the external frames and inserted an internal fracture nail (same day).

 These x-rays were taken 5.5 months after my frame removal/ nail insertion surgery (nearly 6 months of consolidation).  I was roughly 90% consolidated by the time of these images... 

https://imgur.com/a/hjPYMHr

Best of luck to you, please let us know if you speak to any surgeons and what their advice/ guidance is
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174 cm (starting height), 188 cm (current height)

-8 cm femur w/ Stryde in 2019, with Dr. Giotikas (Greece)
-6 cm tibia w/ Taylor Spatial Frames (TSF)  Lengthening and Then Nailing (LATN) in 2023, with Giotikas (Greece)

shortisnotfun

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Re: Is this misalignment? How do I do now?
« Reply #14 on: January 11, 2024, 08:20:17 AM »

It is the blocking screws (free screws behind the nails) that ensure correct alignment without procurvatum. In your case, you don't have a huge problem with procurvatum (it is faily mild).

I am attaching my recent tibia x-rays to illustrate the concept of the blocking screw (please see the Imgur link to my x-rays below).

To give you idea of my timeline, I lengthened my tibias 6.2 cm with TSF External frames. Upon completion of lengthening, my surgeon removed the external frames and inserted an internal fracture nail (same day).

 These x-rays were taken 5.5 months after my frame removal/ nail insertion surgery (nearly 6 months of consolidation).  I was roughly 90% consolidated by the time of these images... 

https://imgur.com/a/hjPYMHr

Best of luck to you, please let us know if you speak to any surgeons and what their advice/ guidance is

Even “mild” procurvatum like this can cause stability issues when standing. I should know because I have procurvatum given to me by one of these doctors and it’s a major issue when standing and balancing.
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My story of how Yuksel Yurttas crippled me:

http://www.limblengtheningforum.com/index.php?topic=85804.0

CLLvet

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Re: Is this misalignment? How do I do now?
« Reply #15 on: January 11, 2024, 02:22:30 PM »

Even “mild” procurvatum like this can cause stability issues when standing. I should know because I have procurvatum given to me by one of these doctors and it’s a major issue when standing and balancing.


Yes, I agree with you. And I'm sorry to hear about that. Which surgeon did you use, if you don't mind me asking? (so others can avoid him)
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174 cm (starting height), 188 cm (current height)

-8 cm femur w/ Stryde in 2019, with Dr. Giotikas (Greece)
-6 cm tibia w/ Taylor Spatial Frames (TSF)  Lengthening and Then Nailing (LATN) in 2023, with Giotikas (Greece)

DonBones

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Re: Is this misalignment? How do I do now?
« Reply #16 on: January 13, 2024, 07:06:11 PM »

Shouldn't that simply remodel back to its original shape?
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shortisnotfun

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Re: Is this misalignment? How do I do now?
« Reply #17 on: May 06, 2024, 10:08:48 PM »


Yes, I agree with you. And I'm sorry to hear about that. Which surgeon did you use, if you don't mind me asking? (so others can avoid him)

The butcher Yuksel Yurttas.
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My story of how Yuksel Yurttas crippled me:

http://www.limblengtheningforum.com/index.php?topic=85804.0
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