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Author Topic: Dr. Alexander Kirienko (Milan, Italy) - Ilizarov Tibia  (Read 10320 times)

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Hobbit99

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Re: Dr. Alexander Kirienko (Milan, Italy) - Ilizarov Tibia
« Reply #31 on: November 29, 2023, 04:04:54 PM »

are you going to bone consolidate with the frames on? i wonder why is that?

Of course. I don't have any intramedullary nail. This is not LON but classic ilizarov. My fixators act as an exoskeleton and bear my whole body weight.
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Currently lenghtening Tibia with Ilizarov method By Alexander Kirienko in Italy

162cm -> 168 cm goal

http://www.limblengtheningforum.com/index.php?topic=84798.msg270786#msg270786

Hobbit99

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Re: Dr. Alexander Kirienko (Milan, Italy) - Ilizarov Tibia
« Reply #32 on: November 29, 2023, 04:42:17 PM »

I also read on this forum somewhere that after fixator removal you lose some millimeters. I asked his assistant and he said it doesn't happen if the bone if strong enough prior to removal. I will also ask him the same question next time just to be sure.
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Currently lenghtening Tibia with Ilizarov method By Alexander Kirienko in Italy

162cm -> 168 cm goal

http://www.limblengtheningforum.com/index.php?topic=84798.msg270786#msg270786

limby101

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Re: Dr. Alexander Kirienko (Milan, Italy) - Ilizarov Tibia
« Reply #33 on: November 29, 2023, 08:45:26 PM »

Are you still on 1 mm/ day?
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Hobbit99

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Re: Dr. Alexander Kirienko (Milan, Italy) - Ilizarov Tibia
« Reply #34 on: November 29, 2023, 09:31:52 PM »

Are you still on 1 mm/ day?

yes. Let's see if he will suggest me to slow down next time.
My next appointment is on december 9
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Currently lenghtening Tibia with Ilizarov method By Alexander Kirienko in Italy

162cm -> 168 cm goal

http://www.limblengtheningforum.com/index.php?topic=84798.msg270786#msg270786

Body Builder

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Re: Dr. Alexander Kirienko (Milan, Italy) - Ilizarov Tibia
« Reply #35 on: November 29, 2023, 10:58:14 PM »

I also read on this forum somewhere that after fixator removal you lose some millimeters. I asked his assistant and he said it doesn't happen if the bone if strong enough prior to removal. I will also ask him the same question next time just to be sure.
No need to ask again, he is right. Most people remove the fixators too soon and they lose about 10% of the lengthened height. I had a very strong callus and didn't lose even 1mm after I removed my monorails.
Also you should slow down. Most llers can turn up to 0,66mm on tibias without any danger of premature consolidation after about 3cm with 1mm per day. If you continue with 1mm till the end then there is a risk of major equinus after 6cm. Even now you have some trouble with keeping.your knees straight as you said which is another reason why you should slow down the distraction rate. With 0,66 mm till 6.5 cm you will be fine.
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Hobbit99

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Re: Dr. Alexander Kirienko (Milan, Italy) - Ilizarov Tibia
« Reply #36 on: November 29, 2023, 11:02:52 PM »

No need to ask again, he is right. Most people remove the fixators too soon amd they lose about 10% of the lengthened height. I had a very strong callus and didn't lose even 1mm.
Also after 3-4cm slow down. Most llers can turn up to 0,66mm on tibias without any danger of premature consolidation after about 3cm with 1mm per day. If you continue with 1mm till the end then there is a risk of major equinus after 6cm.

I don't think I can slow down if he doesn't tell me I should. I will ask. For now I don't have any equinus, just bent knee that it's painful to stretch. He said he was still okay alst time but now after another 4mm I feel it's worse. I'll try to stretch more. If it gets worse before the next appointment I will call him or send him an email.

So you did the lenghtening with a monorail fixator, not circular?
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Currently lenghtening Tibia with Ilizarov method By Alexander Kirienko in Italy

162cm -> 168 cm goal

http://www.limblengtheningforum.com/index.php?topic=84798.msg270786#msg270786

limby101

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Re: Dr. Alexander Kirienko (Milan, Italy) - Ilizarov Tibia
« Reply #37 on: November 29, 2023, 11:23:23 PM »

Hey,
Can you describe your knee issue?
Is that a muscle pain when you straight your leg or is it a knee joint issue or some other thing?
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Hobbit99

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Re: Dr. Alexander Kirienko (Milan, Italy) - Ilizarov Tibia
« Reply #38 on: November 29, 2023, 11:33:19 PM »

Hey,
Can you describe your knee issue?
Is that a muscle pain when you straight your leg or is it a knee joint issue or some other thing?

I think it's the gastrocnemius proximal insertion. I have pain around the knee when I try to straighten the leg, especially the left one. After some stretching I can reach 180 degrees but today for some reason is more difficult. The calf is also bigger and sturdy. Usually after I walk a bit my legs gets straight, but today they were still slightly bent when walking. So my physiotherapist said I need to stretch my legs constantly during the day. Problem is that after a bit with straight leg laying down I get nerve pain, not around the knee but on the lower-anterior part of the leg. It's getting hard, but I knew it.

My feet are still straight with no equinus.
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Currently lenghtening Tibia with Ilizarov method By Alexander Kirienko in Italy

162cm -> 168 cm goal

http://www.limblengtheningforum.com/index.php?topic=84798.msg270786#msg270786

Body Builder

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Re: Dr. Alexander Kirienko (Milan, Italy) - Ilizarov Tibia
« Reply #39 on: November 30, 2023, 04:27:03 AM »

I don't think I can slow down if he doesn't tell me I should. I will ask. For now I don't have any equinus, just bent knee that it's painful to stretch. He said he was still okay alst time but now after another 4mm I feel it's worse. I'll try to stretch more. If it gets worse before the next appointment I will call him or send him an email.

So you did the lenghtening with a monorail fixator, not circular?
Of course you should speak with your doctor first but insist about it. You should not keep the 1mm rate till the end because it is gonna make your soft tissues too stiff and your rehabilitation will be way harder.
Yes I used monorails without any internal nail.
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Beemer m3

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Re: Dr. Alexander Kirienko (Milan, Italy) - Ilizarov Tibia
« Reply #40 on: December 01, 2023, 02:08:27 AM »

Oh so u got no internal nail placed in. How is ur sleep? With the fixator on while bone consolidate I would imagine sleeping would be hard. Well yeh at 4.5cm I got the horrid knee bend too. Probably slow down the lengthening like the guy suggest so u have time to stretch the knee. U put weights on ur thigh closer to ur knee while stretching ur knee straight. It helps.

When I did ilizarov last month I didn't know about the pure externals. Luckily my doctor didn't have that. But I've looked at patient pictures and they removed the frames for bone consolidation. This is new for me but good luck.
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before 168cm current 173.5 cm
ilizarov tibia
sept 2023

goal 2025-26 precice max femur

Hobbit99

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Re: Dr. Alexander Kirienko (Milan, Italy) - Ilizarov Tibia
« Reply #41 on: December 01, 2023, 08:38:23 AM »

Oh so u got no internal nail placed in. How is ur sleep? With the fixator on while bone consolidate I would imagine sleeping would be hard. Well yeh at 4.5cm I got the horrid knee bend too. Probably slow down the lengthening like the guy suggest so u have time to stretch the knee. U put weights on ur thigh closer to ur knee while stretching ur knee straight. It helps.

When I did ilizarov last month I didn't know about the pure externals. Luckily my doctor didn't have that. But I've looked at patient pictures and they removed the frames for bone consolidation. This is new for me but good luck.

In reality pure external is the most common method.

Sleepi is not the best but somehow I manage to. Not a relevant problem. But sleeping with straight legs is impossible.

I emailed him aboud the bent knee and also that I read that one could slow down to give the muscle time to lengthen. He said to continue as I’m doing because this is a common obstacle during lengthening that will go away if I continue to exercise both alone and with my pt.
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Currently lenghtening Tibia with Ilizarov method By Alexander Kirienko in Italy

162cm -> 168 cm goal

http://www.limblengtheningforum.com/index.php?topic=84798.msg270786#msg270786

Beemer m3

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Re: Dr. Alexander Kirienko (Milan, Italy) - Ilizarov Tibia
« Reply #42 on: December 02, 2023, 05:00:30 AM »

my knee started to bend at 4.5cm . around the time i went to remove the frames. it took about 2.5 weeks after frame removal for me to straighten my knee. i had straighten my knee during lengthening but it bent really fast. i guess my stretching didnt keep up with the lengthening. the pt guys didnt give me enough exercises too at the time of lengthening .
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before 168cm current 173.5 cm
ilizarov tibia
sept 2023

goal 2025-26 precice max femur

Hobbit99

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Re: Dr. Alexander Kirienko (Milan, Italy) - Ilizarov Tibia
« Reply #43 on: December 04, 2023, 01:36:04 AM »

No need to ask again, he is right. Most people remove the fixators too soon and they lose about 10% of the lengthened height. I had a very strong callus and didn't lose even 1mm after I removed my monorails.
Also you should slow down. Most llers can turn up to 0,66mm on tibias without any danger of premature consolidation after about 3cm with 1mm per day. If you continue with 1mm till the end then there is a risk of major equinus after 6cm. Even now you have some trouble with keeping.your knees straight as you said which is another reason why you should slow down the distraction rate. With 0,66 mm till 6.5 cm you will be fine.

Body Builder in your case was the amount of lengthening shown at the xrays equal to the actual height gain?
I heard sometimes is less.
So if I lenghtened 6cm should I expect a +6cm or +5.5 cm when measuring my height again?
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Currently lenghtening Tibia with Ilizarov method By Alexander Kirienko in Italy

162cm -> 168 cm goal

http://www.limblengtheningforum.com/index.php?topic=84798.msg270786#msg270786

Tovarish İlizarov

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Re: Dr. Alexander Kirienko (Milan, Italy) - Ilizarov Tibia
« Reply #44 on: December 04, 2023, 05:16:06 PM »

If you do not step on the ground for 4 weeks after the external fixators come off, you will not lose height. Because during this 4-week period, the callus becomes stronger and harder. My suggestion to you is to use parathormone (forsteo needle) because you will not step on the ground for 4 weeks after the fixators come off.Since we will not step on the ground, healing in the bone will be delayed, but you can compensate for this delay in union with a forsteo needle.
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Tovarish İlizarov

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Re: Dr. Alexander Kirienko (Milan, Italy) - Ilizarov Tibia
« Reply #45 on: December 04, 2023, 05:17:24 PM »

I wish the best for you my friend bye
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Hobbit99

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Re: Dr. Alexander Kirienko (Milan, Italy) - Ilizarov Tibia
« Reply #46 on: December 04, 2023, 05:58:45 PM »

If you do not step on the ground for 4 weeks after the external fixators come off, you will not lose height. Because during this 4-week period, the callus becomes stronger and harder. My suggestion to you is to use parathormone (forsteo needle) because you will not step on the ground for 4 weeks after the fixators come off.Since we will not step on the ground, healing in the bone will be delayed, but you can compensate for this delay in union with a forsteo needle.

aren't you supposed to remove the fixator when the callus is already completely healed?
I'm talking about ilizarov - not lon, no internal nail
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Currently lenghtening Tibia with Ilizarov method By Alexander Kirienko in Italy

162cm -> 168 cm goal

http://www.limblengtheningforum.com/index.php?topic=84798.msg270786#msg270786

Tovarish İlizarov

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Re: Dr. Alexander Kirienko (Milan, Italy) - Ilizarov Tibia
« Reply #47 on: December 04, 2023, 07:11:44 PM »

wtf ! If there is no internal nail, the bone alignment problem will arise over time. It is crazy that you choose this method when even those who use internal nails have alignment problems! No doctor should recommend this method.
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Tovarish İlizarov

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Re: Dr. Alexander Kirienko (Milan, Italy) - Ilizarov Tibia
« Reply #48 on: December 04, 2023, 07:15:00 PM »

This method is the most primitive method used by the Soviet doctor Ilizarov. Ilizarov tried to apply this method not to lengthen but to shorten. When his patient turned the screws in the wrong direction, he realized that lengthening could be done by hardening the callus and creating new bone.
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Tovarish İlizarov

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Re: Dr. Alexander Kirienko (Milan, Italy) - Ilizarov Tibia
« Reply #49 on: December 04, 2023, 07:22:23 PM »

Without the internal nail, serious alignment problems would occur.In Turkey, a doctor named Hacı Kutlu performed surgeries using only external fixators and no internal nails, and as a result, crooked bones appeared in her patients.
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Hobbit99

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Re: Dr. Alexander Kirienko (Milan, Italy) - Ilizarov Tibia
« Reply #50 on: December 04, 2023, 07:49:14 PM »

wtf ! If there is no internal nail, the bone alignment problem will arise over time. It is crazy that you choose this method when even those who use internal nails have alignment problems! No doctor should recommend this method.

I did my research on the topic.
Pure externals with circular frames is the one of the safest and cheapest method. It's still used a lot since internal nails like precice are very expensive. Deformities can happen but they can be easily fixed with the fixator. While with LON deformities are less likely to occur, but if they happen then you have to remove the nail with another surgery.
No doctor in Italy does the LON method as far as I know, even the most experienced ones either suggests you pure externals or precice.
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Currently lenghtening Tibia with Ilizarov method By Alexander Kirienko in Italy

162cm -> 168 cm goal

http://www.limblengtheningforum.com/index.php?topic=84798.msg270786#msg270786

TheDream

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Re: Dr. Alexander Kirienko (Milan, Italy) - Ilizarov Tibia
« Reply #51 on: December 04, 2023, 09:13:41 PM »

wtf ! If there is no internal nail, the bone alignment problem will arise over time. It is crazy that you choose this method when even those who use internal nails have alignment problems! No doctor should recommend this method.

I thought one of the advantages of pure externals is that they are better at treating and correcting bone alignment, as you can adjust along multiple directions.
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peter07

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Re: Dr. Alexander Kirienko (Milan, Italy) - Ilizarov Tibia
« Reply #52 on: December 04, 2023, 10:02:53 PM »

I will write in italian since my english sucks, sorry.
Come sta andando fratello?
Posso chiederti come si è svolta l'operazione? Sei stato operato all'Humanitas? Sei stato li in degenza oppure sei tornato subito a casa? In generale come è il Dott.Kirienko magari rispetto ad un Pili? Ho visto il sito ma non sembra menzioni trattamenti a fini estetici... come dovrei approcciarmi? Basta una mail o altro?
Inoltre, se posso, quanto sono lunghe ile tue braccia? Io sono alto 165 e vorrei arrivare a 175 circa facendo sia tibie che femori, magari tu che ci hai parlato puoi darmi qualche dritta?
Scusa per la tempesta di domande, ma è da quando ho scoperto st'operazione che non ci dormo la notte ;D
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Body Builder

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Re: Dr. Alexander Kirienko (Milan, Italy) - Ilizarov Tibia
« Reply #53 on: December 04, 2023, 11:02:03 PM »

Body Builder in your case was the amount of lengthening shown at the xrays equal to the actual height gain?
I heard sometimes is less.
So if I lenghtened 6cm should I expect a +6cm or +5.5 cm when measuring my height again?
I gained exactly what was shown in the x rays. But my callus was complete when I removed the frames so I didn't lost even 2mm.
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Body Builder

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Re: Dr. Alexander Kirienko (Milan, Italy) - Ilizarov Tibia
« Reply #54 on: December 04, 2023, 11:03:30 PM »

wtf ! If there is no internal nail, the bone alignment problem will arise over time. It is crazy that you choose this method when even those who use internal nails have alignment problems! No doctor should recommend this method.
You are completely irrelevant about how LL works. And your advice (about now walking for 4 weeks etc) are plain bs.
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Hobbit99

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Re: Dr. Alexander Kirienko (Milan, Italy) - Ilizarov Tibia
« Reply #55 on: December 04, 2023, 11:09:53 PM »

I will write in italian since my english sucks, sorry.
Come sta andando fratello?
Posso chiederti come si è svolta l'operazione? Sei stato operato all'Humanitas? Sei stato li in degenza oppure sei tornato subito a casa? In generale come è il Dott.Kirienko magari rispetto ad un Pili? Ho visto il sito ma non sembra menzioni trattamenti a fini estetici... come dovrei approcciarmi? Basta una mail o altro?
Inoltre, se posso, quanto sono lunghe ile tue braccia? Io sono alto 165 e vorrei arrivare a 175 circa facendo sia tibie che femori, magari tu che ci hai parlato puoi darmi qualche dritta?
Scusa per la tempesta di domande, ma è da quando ho scoperto st'operazione che non ci dormo la notte ;D

Edit: sorry guys for replying in italian. I will add a translation later if I have time.

Ciao
Il giorno prima ho fatto vari esami pre operatori, ho dormito in albergo a rozzano e la mattina dopo mi hanno ricoverato (humanitas) e subito operato. Intervento in anestesia spinale quindi ero sveglio ma sonnecchiante perché mi avevano dato anche qualcosa per schiacciare un pisolino. Puoi fare anestesia generale se vuoi, sono io che ho optato per la spinale. Con la spinale ti mettono il catetere per un giorno circa. Intervento durato circa 4 ore. Degenza di 3 giorni e poi a casa. Abito a Roma e per fortuna visita anche a Roma. Ogni due settimane durante l’allungamento.
Il dottor Kirienko è russo, mi sembra molto bravo, ma non ho abbastanza esperienza per giudicare. È più anziano di pili. Il costo è più o meno uguale. Avevo fatto anche la visita con Pili e mi sembrava anche lui molto preparato, quello che non mi convinceva molto è la facilità con cui suggeriva un secondo intervento di allungamento del tendine d’achille sopra i 5cm nel caso della tibia. Non c’è molta letteratura in giro riguardo allungamenti del tendine in soggetti adulti e a fini estetici. Qui sul forum alcuni ritengono che si perda permanentemente forza muscolare allungando il tendine, avendo permanentemente difficoltà a correre, ma Pili dice di no. Non so bene a chi credere. Kirienko invece mi ha detto che lui non fa l’allungamento del tendine perché problemi come piede equino e contrattura del ginocchio si risolvono con fisioterapia pesante se a gradi lievi, insomma la fa molto più facile. Il discorso che fa è, se ho capito bene, che nella maggior parte dei casi non serve allungarlo e che piuttosto che arrivare ad un punto in cui diventa strettamente necessario ci si ferma prima con l’allungamento.
Poi magari Kirienko sbaglia e ha ragione Pili, non lo so. Mi sembrano comunque entrambi molto esperti, solo un’opinione diversa rispetto a questo tendine.
Ho le braccia corte, me lo ha detto Kirienko. A casa ho provato a misurarmi la wingspan e se non sbaglio era di 156cm. Ho anche le mani molto piccole che sicuramente mi tolgono qualcosa. Sinceramente però a vedermi allo specchio non mi vedo sproporzionato e anche se dovessi esserlo leggermente dopo l’intervento beh lo preferisco rispetto a essere più basso del 98% della popolazione maschile. Comunque Kirienko mi ha consigliato di non andare oltre 6, massimo massimo 7 cm sia per discorso proporzioni che ripresa funzionale.

Kirienko credo che faccia meno casi estetici di Pili, o almeno si pubblicizza meno, ma credo che, come dice anche Paley (Paley che tra l’altro conosce sia Pili che Kirienko) se un chirurgo è esperto di allungamenti in persone con serie patologie allora è esperto anche di allungamenti estetici, essendo più semplici.
Comunque sul sito c’è una pagina un po’ nascosta dedicata all’allungamento estetico: https://kirienko.org/allungamento-estetico/

Non sono sicuro che Kirienko allunghi anche i femori per fini estetici, dovresti chiederlo. Sul sito ci sono solo esempi di tibia ma a me quella interessava (anche per questioni economiche). Se mandi una mail ti risponde in breve.
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Currently lenghtening Tibia with Ilizarov method By Alexander Kirienko in Italy

162cm -> 168 cm goal

http://www.limblengtheningforum.com/index.php?topic=84798.msg270786#msg270786

Hobbit99

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Re: Dr. Alexander Kirienko (Milan, Italy) - Ilizarov Tibia
« Reply #56 on: December 04, 2023, 11:22:33 PM »

I gained exactly what was shown in the x rays. But my callus was complete when I removed the frames so I didn't lost even 2mm.

Thanks. I will wear the fixators as long as necessary.
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Currently lenghtening Tibia with Ilizarov method By Alexander Kirienko in Italy

162cm -> 168 cm goal

http://www.limblengtheningforum.com/index.php?topic=84798.msg270786#msg270786

lucindaris

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Re: Dr. Alexander Kirienko (Milan, Italy) - Ilizarov Tibia
« Reply #57 on: December 05, 2023, 04:36:55 PM »

Do you have a correct contact e-mail to the company/him because he doesnt seem to answer my email.
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Hobbit99

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Re: Dr. Alexander Kirienko (Milan, Italy) - Ilizarov Tibia
« Reply #58 on: December 05, 2023, 04:57:03 PM »

Do you have a correct contact e-mail to the company/him because he doesnt seem to answer my email.

alexander@kirienko.com he usually responds in 1-3 days here
I also have his phone number but I'm not sure if I can share it, maybe it's for patients only, I don't know.
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Currently lenghtening Tibia with Ilizarov method By Alexander Kirienko in Italy

162cm -> 168 cm goal

http://www.limblengtheningforum.com/index.php?topic=84798.msg270786#msg270786

Hobbit99

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Re: Dr. Alexander Kirienko (Milan, Italy) - Ilizarov Tibia
« Reply #59 on: December 05, 2023, 05:01:58 PM »

Update: rather than ballerina, I have problem with my feet slightly "rotating" inward? Not sure How I can express it.
During my first visit he said I have "piede pronato valgo" (not sure how it's spelled in english, but it's a type of flat foot) and that it could be an obstacle during lengthening. I will ask him to check my feet during our next appointment hoping it's just a form of equinous (ballerina) that will go away with time.
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Currently lenghtening Tibia with Ilizarov method By Alexander Kirienko in Italy

162cm -> 168 cm goal

http://www.limblengtheningforum.com/index.php?topic=84798.msg270786#msg270786

Beemer m3

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Re: Dr. Alexander Kirienko (Milan, Italy) - Ilizarov Tibia
« Reply #60 on: December 06, 2023, 02:07:41 AM »

That happened to my neighbor. But I rarely talk to him. It's another form of ballerina foot just in a different direction. He lengthen 8cm btw. Right now u should be taking care of the foot. When its time to walk again with a walker it should go slightly down with time but not all the way. I still feel mines after 5 weeks. If I stand straight to the fullest. I got regular ballerina foot. I took care of my feet but it wasn't enough I guess. They also got foot splints to help at night but in ur case u can't wear it because of the device.
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before 168cm current 173.5 cm
ilizarov tibia
sept 2023

goal 2025-26 precice max femur

Hobbit99

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Re: Dr. Alexander Kirienko (Milan, Italy) - Ilizarov Tibia
« Reply #61 on: December 06, 2023, 04:10:29 AM »

That happened to my neighbor. But I rarely talk to him. It's another form of ballerina foot just in a different direction. He lengthen 8cm btw. Right now u should be taking care of the foot. When its time to walk again with a walker it should go slightly down with time but not all the way. I still feel mines after 5 weeks. If I stand straight to the fullest. I got regular ballerina foot. I took care of my feet but it wasn't enough I guess. They also got foot splints to help at night but in ur case u can't wear it because of the device.

You finished lengthening 5 weeks ago? By the way there is still time to recover I guess.
I don't have a "splint" but I have an elastic band that keeps my feet dorsiflexed. I'm already walking with the walker, I try to walk at least 1 time every day, but it's getting harder now because my legs are not straight. The doctor said the knee bent problem is a common obstacle, I will also ask about the feet this saturday.
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Currently lenghtening Tibia with Ilizarov method By Alexander Kirienko in Italy

162cm -> 168 cm goal

http://www.limblengtheningforum.com/index.php?topic=84798.msg270786#msg270786
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