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[Ted68]

Today marks 4 month and 4 days (124 days) since tibia surgery... and I got almost zero callus in tibia. But fibula has a significant callus.
I am scared about that, because doctor said I can do full bearing on my legs and he expect from me to walk pretty good with the rolling walker, but I have no callus and big pain. Also I have a missing screw in left tibia !
Of course, I walk in the pool and do tendon stretch a lot.
Here you can see my last x-rays, which I did 2 days ago. Frontal and sagital...

https://photos.app.goo.gl/YdWd3wYzjXzsFFQC9

https://photos.app.goo.gl/XyjYfgXswnT75qxw7

I am waiting from you guys, who had tibia surgery, to tell me your experience and when exactly you got a clear callus after surgery...

[limby101]

Hey
Do you have x-rays of your tibias that shows the whole length of the bone? So we can see the ends screws that join tibia and fibula.
Im not sure by the pictures you put, if tibias and fibula were screwed together on both ends, it is required to prevent fibula migration during tibia lengthening.
About your tibia healing, yes we can see the gap but there's also callus formation visible. The tibia takes long time to heal, 2 or maybe 3-4 times the time it takes for femur, and considering your age, and the fact you did quadrilateral (it means a lot of bone tissue formation required in the same time....) it maybe expected to take a long time for tibia to consolidate. So I think you're going to have to be very patient. Also not bearing weight (because precice is not weight bearing) reduces the stimulation for bone formation...
I would advise to get a second opinion of an expert about the angle of your knee.

Keep working out those muscles to increase blood flow, get some sun, good food and supplement and stay optimistic
I will pray for your speedy recovery

[Ted68]

Hey
Do you have x-rays of your tibias that shows the whole length of the bone? So we can see the ends screws that join tibia and fibula.
Im not sure by the pictures you put, if tibias and fibula were screwed together on both ends, it is required to prevent fibula migration during tibia lengthening.
About your tibia healing, yes we can see the gap but there's also callus formation visible. The tibia takes long time to heal, 2 or maybe 3-4 times the time it takes for femur, and considering your age, and the fact you did quadrilateral (it means a lot of bone tissue formation required in the same time....) it maybe expected to take a long time for tibia to consolidate. So I think you're going to have to be very patient. Also not bearing weight (because precice is not weight bearing) reduces the stimulation for bone formation...
I would advise to get a second opinion of an expert about the angle of your knee.

Keep working out those muscles to increase blood flow, get some sun, good food and supplement and stay optimistic
I will pray for your speedy recovery

Sure, man, here you can see the distal part of same tibia...

https://photos.app.goo.gl/dwKqCLGWNysWKpJd6

... but I am not sure how it helps you.

Anyways, all you said is right and we all know that... but I asked people who already did Quad Precice to let me know when they started to get clear callus on their tibias... because I already have more than 4 months.

Thank you !

[Ted68]

7 JUNE 2024

Since I started the recovery here in my country, in good conditions with warm and salted water pool, I gained double strength in my legs, better balance in free walking in water and I could start with no problem using rolling walker.
In Turkey I could use walker for only 10 metres, with huge pain, only on tip toes. Now I can use it for 50 m and no rest, also I can walk almost normal touching both heels to ground.
But, in the last week, before pool and walker I take a strong dose of Voltaren, so I can force myself. So, that’s why I can double my effort and intensity. The only one problem now is my muscle soreness, which is very annoying. But this is a good sign for muscle mass regain.

Next week I want to start walking without rolling walker, so I want to walk along railing on the wall with one hand and then return with the other hand.
I will also start to walk up on stairs.
Obviously, for all these I will need a cane.

In approximately 10 days I will leave this place and go home !
Few days before leaving I will do another x-ray, so I can see if walking and forcing on my tibias started a clear callus formation…

[Bob]

Day 95-98

After finishing elongation I had 3 days of no elongation, but the happiness is not forever, because i have done the x-rays and 2 days later doctor gave me a bad news that my right tibia has late and slow callus formation… so I have to do reversing cycles so it could start the normal process…
The left tibia is a bit better but not great, so he advised me to do it on both.

Ohh, great !... so now I have to start over the schedules for the lengthening machine, for 3 weeks…

The PT is painful for me every day, as I told you already.

As you can see, I am busy permanently, never relaxed so I could sleep well…

Ted68, when you did compression then distraction in tibia how fast did you do this - how many mm per day? Also, when you did the compression, was it all the way down to the osteotomy site and from that site you began distraction?

Any update of your situation?

[Ted68]

Ted68, when you did compression then distraction in tibia how fast did you do this - how many mm per day? Also, when you did the compression, was it all the way down to the osteotomy site and from that site you began distraction?

Any update of your situation?

Hi, Bob...
I did it normally, 1mm per day, in 3 sessions, as I wrote.
Man, this procedure is 5mm back and 5 mm forth, retraction and regain, results 20 days of procedure .... not all the way back !
Thats why it is named "accordion procedure".
First of all, if you do all the way back, it is very dangerous to the soft tissues that you already stretched 40mm... and it will take 80 days total, don't you think ?

[Bob]

Hi, Bob...
I did it normally, 1mm per day, in 3 sessions, as I wrote.
Man, this procedure is 5mm back and 5 mm forth, retraction and regain, results 20 days of procedure .... not all the way back !
Thats why it is named "accordion procedure".
First of all, if you do all the way back, it is very dangerous to the soft tissues that you already stretched 40mm... and it will take 80 days total, don't you think ?

Ohh that's why you and your doctor decided not to go all the way back, that make sense. Silly me, I'm not a doctor I just thought you did go all the way back and distracted from there.

Are you doing ok?

[Ted68]

Well, I am not doing very well, but thanks for asking !

I returned home and I struggle to walk, but is very painful. The pain is same like 2 months ago, when I tried first time to use the walker. So, if I don't take 100mg Voltaren, i cannot walk !
I put away the wheelchair and now I walk only with 2 special canes or with the rolling walker. I bought 2 tetra-pod canes, which are best.
But I am home and, at least, nobody disturb me ... which is great, after 6 months of  ty life and being disturbed every day, many times a day !
I eat whatever I want, whenever I want and I can return to my regular and very controlled life style by myself, not by others !
Now I will do an x-ray much less often.
Overall I am less stressed.

[Bob]

Good you are less stressed.

[Ted68]

23 June 2024

Today marks 6 months since my first surgery, on Dec 23 !!

This is a summary after 6 months and what I got:

-   Underwent 3 surgeries (because I had to replace a bent femural implant)
-   Lots, lots of suffering !
-   Gained 120mm as height
-   Got chicken legs because muscle atrophy
-   No strength in my legs muscles. Without canes I cannot stand up at all, from bed or toilet
-   I got a good callus on both femurs
-   The callus on tibias didn’t start clearly so far
-   Unfortunately I got a slighyly curved implants on both femurs. Thanks God is not worse !
-   I lost one proximal screw from left tibia, because started to come out of bone, so now all my weight stays on one tibial screw … and that scares me
-   I stayed 5 weeks in a special recovery clinic, after returning in my country, doing exercises in pools with warm salted water, where I achieved what I couldn’t achieve in Turkey
-   The knees are both still semi-flexed
-   Now the heels are down on the ground when I walk, but I have duck b-utt. The right tibial tendon is stiffer, so is behind the right one which keeps the heel down much more relaxed. I am wondering when will I stand normally vertical…
-   I moved back home and I put away my crappy wheelchair and now I use only walker or two canes. A big step forward !
-   I started walking exercises every day and now I can walk  15 steps without help and I can stand up for 1 minute, without help.
-   Finally I can pee like boys, because for 6 months I peed like girls…
-   Still have same bad pain in knees and tibias like before and I must take a strong Voltaren so I can walk
-   Now I got a new pain: in the right hip... I have it permanent when hip rotation, on the bed and on standing up. I don’t know what is this, but is like a knife !
-   Now I have to check again my tibial callus, so I will see on my next x-rays what happened in the last 3 weeks after starting intense full bearing walking. I have to find in few days an imaging clinic close to my house
-   Now I take only Calcium + D3, Colagen, Creatine and Proteins
-   Overall, I don’t understand why I still have excruciating pain when walking,  because its been 2 months since standing up and started to walk. Doctor Gokhan said that pain will go away, but I feel the pain is worse and worse. Going to toilet or to eat is a nightmare, when I don’t take Voltaren. And voltaren I take only one time a day, before walking exercises … in the rest only nightmare !... I stay 1 minute anytime before standing up, to prepare my mind for a new pain !
-   I never could really measure my new height, because my tip toes standing and because knee semi-flexion, plus the “duck b-utt”. Anyways, that moment will come in few weeks, as I feel
-   In few days I will try again to drive my car, because 6 weeks ago I tried but my right foot couldn’t control the acceleration
-   But, at least, every day I feel I am much taller and I am amazed every time when I stand up…

[Mike G]

Hello dear Ted.
I read your last post. I hope you're doing well (as can be considering all..).
Since you still tackle many obstacles, perhaps it would be good idea to get another consultation at this point from another LL orthopedic surgeon for proper continuation of your recovery ?

I sure don't want you to suffer from some permanent pain because of complications :/

Also, it sounds like you endure some delayed consolidation of the tibia from what you describe ?
Perhaps a special focus is required regarding how to help more callus / bone growth in that area ?

I'd be happy to hear how you're doing overall. Stay strong friend.

[Ted68]

Hi, Mike.
Thank you for your message.

Actually I was talking with 2 orthopedist already, but they are reserved because they never seen this extreme procedure yet and they don't know how is going on. This is available for most countries in the world, because real and serious LL is happening only in 5 countries maybe...

Yes, the biggest concern are the sequels after this procedure...

Regarding tibia callus, I need to find a convenient place to do x-rays every month from now... because now I am on my own and is not easy.

[limon]

https://photos.app.goo.gl/XyjYfgXswnT75qxw7

I think you have antecurvation deformity. The bone has moved away from the original by about 5-8 degrees. It's hard to determine the angle, but yours is now about 74 (normal 77-84)

https://library.rniito.org/download/manuals/Opredelenie_referentnykh_liniy.pdf

[Ted68]

I think you have antecurvation deformity. The bone has moved away from the original by about 5-8 degrees. It's hard to determine the angle, but yours is now about 74 (normal 77-84)

https://library.rniito.org/download/manuals/Opredelenie_referentnykh_liniy.pdf

I asked doctor about that and I am waiting for his opinion...
Thank you

[Ted68]

28 June 2024

I have 2 good news, guys:
Because my everyday struggle doing walking exercises.... today I drove safely my car !
and
I took the car, I drove to imaging clinic and I did today new x-rays... and finally I can see the clear callus formation !

https://photos.app.goo.gl/HpznVTXfYGqgYnSb8

https://photos.app.goo.gl/HHb8Nt7t25skbJU49

[onedaytall]

28 June 2024

I have 2 good news, guys:
Because my everyday struggle doing walking exercises.... today I drove safely my car !
and
I took the car, I drove to imaging clinic and I did today new x-rays... and finally I can see the clear callus formation !

https://photos.app.goo.gl/HpznVTXfYGqgYnSb8

https://photos.app.goo.gl/HHb8Nt7t25skbJU49

Congratz! Must've been scary going through everything and not seeing callus formation. The countdown to you enjoying new life with your new height is definitely on.

I've been a lurker on this thread, read it all through. Inspiring to see you going through all these struggles and periods of uncertainty with determination and now things seem to be turning in your favor here finally.

[Ted68]

Congratz! Must've been scary going through everything and not seeing callus formation. The countdown to you enjoying new life with your new height is definitely on.

I've been a lurker on this thread, read it all through. Inspiring to see you going through all these struggles and periods of uncertainty with determination and now things seem to be turning in your favor here finally.

Thank you, man !
This diary is for you, my lurkers... because I know you are many... otherwise I couldn't have 15.000 views !

Yes, I was scared while passing through 4 months and zero callus in tibia...
My doctor always said to me: "- Start walking, because only walking will trigger your tibial callus formation ! "... so, I did it finally and 3 weeks later the callus appeared. He was right !

Of course, my problems didn't stop here, because I got many, but at least the new bone is growing... so non-union is not a problem anymore

[Ted68]

2 July 2024

Today I got 16.000 views, thats good !... This means my diary is successful.

Dr. Gokhan was happy that I got callus in tibias and I could drive my car !
And keep in mind guys, my car is manual, so hard to drive !... and I live in the capital of my country, where the traffic is crazy.

He said then: "Now is time to remove your ankle screws, so find an orthopedist !"
So, now I have to find one and do it.

For those who don't know, the 2 screws are only for short time, to keep your ankle stable during lengthening, but once callus is started you don't need them because it stays against your ankle mobility. And this is right, because whenever I force my ankle tendon I feel pain in that spot, where the screws are.
BTW, you can see the screws in my last xrays I showed you.

[wes07]

How is Ghokan better than Giothikas?( I'm sorry if I misspelled their names)

[Ted68]

How is Ghokan better than Giothikas?( I'm sorry if I misspelled their names)

If you do a search in this forum, you will find how...

[wes07]

How soon are you able to drive your manual car after finishing the lengthening phase? Because I want to be able to drive my manual car to work after I travel back home.

[Ted68]

How soon are you able to drive your manual car after finishing the lengthening phase? Because I want to be able to drive my manual car to work after I travel back home.

Nobody can tell you that !
Every person is unique, with a different path and different healing pace...

[shortisnotfun]

Thank God you didn’t get as crippled as I did with the butcher Yuksel Yurttas

[Ted68]

27 July 2024

Guys, i am in deep s-hit. My both right tibial proximal screws wants to go out !

https://photos.app.goo.gl/kEBojeaZ6usn2k51A
https://photos.app.goo.gl/LH76UduzRkVzFJxX9
https://photos.app.goo.gl/EEmoJi1ziri38MRVA

This is the result of walking exercise, which actually started my tibial callus finally.
So, as you can see, if i dont exercise i get no callus. But if i exercise, my screws pops up like crazy !
I lost a screw to my left tibia, but the remained one is stable. Unfortunately,  the right tibial screws wants to come out both, in the same time.
So, i am fu**ed !
My problems never stop coming, I don't know what is going on !

These engineers who created the Precice system should take care of every bad situations are coming and to prevent them.
My screws has only 5 mm thread, the rest being only smooth metal which pass through the nail. But, because the strong forces in the bones when walking, that thread broke  the bone very easy and the screw has no stability point anymore and move freely !
And I am slim, only 74 kg at 1.82 height, so nobody can say "Well, you are fat !"

So, this is unacceptable !
Now i stopped my normal daily exercise, so I stopped my recovery !...
I only go from bed to kitchen and to bathroom. The rest i stay in bed, just not to loose completely my screws. Until I will not have a strong callus in my tibias I cannot do anything, but the callus could be strong enough in one year from now !

I hoped I could start walking freely in maximum 3 months, because I have a flight ticket and I didn’t want to go with walker or canes… but now I am pretty sure I have to postpone everything !

I don’t know if there is a resolve for my problem, because the doctor cannot remove it and replace it with something better. He said all it can be done is to cut my skin and to push back the screws.
I am desperate and I am not sure if I can fix this s-hit.
Tell me guys if you had this problem and how you managed it...

[wes07]

Have you thought about getting a bone graft to speed up the healing process? I think you should consult with Paley and see what he says about you nonunion condition.

[Ted68]

Have you thought about getting a bone graft to speed up the healing process? I think you should consult with Paley and see what he says about you nonunion condition.

Well, if dr Gokhan didnt decide that while I stayed in Istanbul, now is too late.
As you should know, my callus started 1 month ago, so I don't have non-union... its only delayed-union !

[Mike G]

It looks extremely painful. 

Do you think it may be wise to get second opinion from another LL orthopedic surgeon (perhaps even overseas online consultation) because there's no way you're the first person something like this happened to during lengthening process (?).

[Ted68]

It looks extremely painful. 

Do you think it may be wise to get second opinion from another LL orthopedic surgeon (perhaps even overseas online consultation) because there's no way you're the first person something like this happened to during lengthening process (?).

Yeah, always is better to get a second opinion from best doctors. The question is if they answer and how much it cost... because they treat your "question" as a consultation and charge you hundreds dollars...

[heightiseverything]

27 July 2024

Guys, i am in deep s-hit. My both right tibial proximal screws wants to go out !

https://photos.app.goo.gl/kEBojeaZ6usn2k51A
https://photos.app.goo.gl/LH76UduzRkVzFJxX9
https://photos.app.goo.gl/EEmoJi1ziri38MRVA

This is the result of walking exercise, which actually started my tibial callus finally.
So, as you can see, if i dont exercise i get no callus. But if i exercise, my screws pops up like crazy !
I lost a screw to my left tibia, but the remained one is stable. Unfortunately,  the right tibial screws wants to come out both, in the same time.
So, i am fu**ed !
My problems never stop coming, I don't know what is going on !

These engineers who created the Precice system should take care of every bad situations are coming and to prevent them.
My screws has only 5 mm thread, the rest being only smooth metal which pass through the nail. But, because the strong forces in the bones when walking, that thread broke  the bone very easy and the screw has no stability point anymore and move freely !
And I am slim, only 74 kg at 1.82 height, so nobody can say "Well, you are fat !"

So, this is unacceptable !
Now i stopped my normal daily exercise, so I stopped my recovery !...
I only go from bed to kitchen and to bathroom. The rest i stay in bed, just not to loose completely my screws. Until I will not have a strong callus in my tibias I cannot do anything, but the callus could be strong enough in one year from now !

I hoped I could start walking freely in maximum 3 months, because I have a flight ticket and I didn’t want to go with walker or canes… but now I am pretty sure I have to postpone everything !

I don’t know if there is a resolve for my problem, because the doctor cannot remove it and replace it with something better. He said all it can be done is to cut my skin and to push back the screws.
I am desperate and I am not sure if I can fix this s-hit.
Tell me guys if you had this problem and how you managed it...

Hi, I am pretty new to this. Was wondering to ask why exactly the screws got loose? Does it usually happen with Precice because I've never heard about it on this forum, maybe doctor's error or something else?

[Ted68]

Actually this is the question I asked here, because I don't understand either.
My doctor said "is because the late callus formation and the screws cannot resist to all this effort you put on them during your walking exercises". OK, sir...

There are few guys who did Precice on tibia, but they are not coming here to tell me their experience.
So, for now I confront myself with this s-hit and I stopped walking exercise and the recovery, just to keep the screws in actual position... Otherwise, if are coming out, I will be completely handicapped and I will stay again in wheelchair to the completely callus formation...

[Ted68]

8 Aug 2024

Yesterday I did again x-rays, so I can see how is my callus and my popping-up screws.

https://photos.app.goo.gl/U7viA1ervFWQdiXA9

https://photos.app.goo.gl/JJLcNqqEiA4kqqei6

So, as you can see, I got a massive callus on femurs, which is better than expected, and more callus than 42 days ago in tibias, when I had previous x-rays... which is good !
You can go on my 27 June post and compare…

But, as you can see on right tibia, the upper screw has the thread completely out... so thats why I stopped my walking exercises...

If you remember, 2 months ago doctor Gokhan asked me to go and remove my temporary ankle screws... But, guys, I never thought the doctors in my country are so st-upid !
I was talking with 3 of them and they are afraid to do it... Its unbelievable !
Also, I want them to screw back my upper proximal one... but no chance. I showed them all technical information, as size, length, hex wrench, etc, and nothing.
And I am talking about the best and busiest orthopedic hospital in my country, not a rural one.
They pi-ssed me off, they all blame me saying I am stupid and I wasted my money and I risked my health... but no one want to help me because they are afraid to not make a mistake !...
A bunch of pu-ssies !

I really don't want to waste money and time to go in Istanbul for a 10 minutes surgery session, because that would be re-tarded, and my doctor agreed that... But he said finally would be the only solution.
Now I am still looking for a brave one...

I stopped my walking daily routines and I lost flexibility, strength and endurance... but I have no choice.
I am happy at least I can still drive my car.

I am sad and frustrated...