Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[Hamza]

@Hamza
The danger of nerve damage or problems normally start after 3-4 cm mark and as i understand it 1 cm (even if it was done all togather) does not pose any danger to nerve or ligament damage. At worst it will just makes you uncomfortable for few days.

Please understand that CLL surgeons are not better than deformity/correction surgeons, they just have more experience delaing with bilateral Cosmetic LL cases. In your case its not bilateral lengthening and its definitely not CLL, in my opinion yours is a straight forward case LL discrepancy correction which can and should be corrected with acute lengthening and than nailing allowing you to get on with your life. This can be done by ANY respectable experienced lower limb deformity correction surgeon even in your home country. Here the key is to look for surgeon who is experienced in lower limb correction surgeries.

This is not a medical advice as i am not qualified to do so and the decision is yours as its your money and legs. Do what you feel most comfortable with.

Good Luck.

I understand you and many thx.

If choosing another doctor is just for saving money but same have same level of expertise I prefer to keep my surgery appointment with Dr Betz in a couple of weeks as i saw him and talked to him for hours and I felt comfortable when I saw his confidentiality in what he is going to do.

None of the real orthopedic surgeons in Europe will take a decision before he sees me and I ll end up spending money and time, unless u believe that real ortho. surgeons can be more professional for my case.

In my country, the problem is no one of the Dr s used telescopic nail before (not available, only external is used and rarely) and they said we can help u and pull it out but better to pull it out with a Dr that is experienced with it because the head of the nail needs special tools to be easily removed same for the screws.

[Infinity]

I understand you and many thx.

If choosing another doctor is just for saving money but same have same level of expertise I prefer to keep my surgery appointment with Dr Betz in a couple of weeks as i saw him and talked to him for hours and I felt comfortable when I saw his confidentiality in what he is going to do.

None of the real orthopedic surgeons in Europe will take a decision before he sees me and I ll end up spending money and time, unless u believe that real ortho. surgeons can be more professional for my case.

In my country, the problem is no one of the Dr s used telescopic nail before (not available, only external is used and rarely) and they said we can help u and pull it out but better to pull it out with a Dr that is experienced with it because the head of the nail needs special tools to be easily removed same for the screws.

You could do a lot worse than going with betz most CLL doctors started as normal lower limb or orthopedic surgeon and betz is an experienced orthopedics surgeon. IMO he is a little greedy and sometimes takes too many risks but that's probably in CLL case. Your case is pretty straight forward corrections case so I don't see any issues with choosing betz. If you can afford him and  money is not an issue than go for it, get it done and move on with your life. You seems like a decent guy so I wish you all the best with surgery!

[Hamza]

You could do a lot worse than going with betz most CLL doctors started as normal lower limb or orthopedic surgeon and betz is an experienced orthopedics surgeon. IMO he is a little greedy and sometimes takes too many risks but that's probably in CLL case. Your case is pretty straight forward corrections case so I don't see any issues with choosing betz. If you can afford him and  money is not an issue than go for it, get it done and move on with your life. You seems like a decent guy so I wish you all the best with surgery!

Yes I decided to go with him and I ll let u know the result next month.
Attached an xray done today (13 months post sugery).

https://imgur.com/a/gCWJHGL

I feel that i will not need bone grafting, do u agree with me ?
Do u think when we cut the bone again to gain 1 cm the old fracture will break or it looks solid enough ?

[E Z]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5932753/#!po=2.08333

Not sure how helpful this is, but this is a case similar to yours.

from what I'm gathering, after initial lengthening goals were reached, the nail failed and reversed. Author hinted at weight bearing capabilities of the precise nail being limited as to the reason.

[Infinity]

Yes I decided to go with him and I ll let u know the result next month.
Attached an xray done today (13 months post sugery).

https://imgur.com/a/gCWJHGL

I feel that i will not need bone grafting, do u agree with me ?
Do u think when we cut the bone again to gain 1 cm the old fracture will break or it looks solid enough ?

I think you have good consolidation and probably wont be needing any grafting but i think the best person to decide this will be your surgeon. try to listen to him and not impose your opinion as afterwards he will blame you if something will not be right.

It will be wise to re-brake it at the old osteotomy site but again let the surgeon take care of this. he knows the best.

Once again Good luck!

[Hamza]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5932753/#!po=2.08333

Not sure how helpful this is, but this is a case similar to yours.

from what I'm gathering, after initial lengthening goals were reached, the nail failed and reversed. Author hinted at weight bearing capabilities of the precise nail being limited as to the reason.

Yes when i started walking after 3 months, I was happy with the result.
After that, Dr Allowed me to walk and I started gradually feeling that I need to start adding insoles of 3,5,7... mm s again.

[Hamza]

My correction surgery is on the 10th of October 2019. I will keep you updated.

[Hamza]

Surgery is successful, Thanks GOD !!!
I full weight bear since the 1st day post surgery.
I am leaving the hospital tomorow morning.

[Michael01]

I'm happy for you, Hamza. Solid trauma nail will not shorten the distraction. Please, keep us updated on your consolidation.

[bgreeneee]

Good news Hamza,

[Hamza]

Thanks GOD that I did the correction with Dr Betz.

Everything was perfect from A to Z, starting from the 5 star hospitality, 2 hours discussion in details at night in the room with Dr Betz the great listener and the great speaker, Blessed hands that saved my leg, down to earth as he came after surgery and helped me to wear my boxer and short I realy felt that he is my father and not my doctor, decent professional high in morals.

I regret that i didnt chose him from the first begining and used solid nail and avoided complications of telescopic nail which in his opinion was not the best choice for my case and i had the chance to walk directly after the surgery.

Dr betz used the same old fracture, cleaned it, lengthened 1 cm, bone graft from illiac crest, put a solid nail of 12 mm diameter because the precice was 12 mm diameter.
All what I care about now is that my bone heals at the end so I am following up with the top notch Dr Betz via email, phone and whatsapp.

I ll provide u with my new xray as soon as i go back to office.

Thanks GOD.
Wish u guys all the best.

[Michael01]

Good to know everything end up fine for you, Hamza. Now you can enjoy your life without discrepancy. This is awesome!

[Hamza]

Xrays uploaded.

I corrected the 9 mm difference in femur so i end up having equal femurs and I still have 5 mm difference (3 in tibia and 2 in ankle).
I am easily puting an insole of 3 mm to feel fully balanced and comfortable.

Straight after acute lengthening of 9 mm:
https://imgur.com/SG2Pdd0
https://imgur.com/XI6zxws


Two months post acute lengthening of 9 mm:
https://imgur.com/uMqJnkN
https://imgur.com/B8iSUG8

After 2 months of the surgery my walk is 70% back to normal (still far away from running).
I am still swaying a little bit but I am not using a cane for balance since 3 weeks ago.
Pain is still in the thigh but less by like 60% .
doing PT 2 times per week ( cant afford more ).
I feel that i need like 6 months post surgery to be able to walk normally & 1 year to be able to run.

Dr Betz said that I can do whatever activity I want with no limits and bone healing is good.

[Hamza]

3 months 10 days post surgery:

My gait is 80% back to normal.
Pain is 90% less when walking.
I can go upstairs/downstairs without support but i need to be cautious due to some weakness in thigh.
I feel that I need 2 more months to be able to start running.
This kind of surgeries needs a lot of responsibility (stretching, strengthening) and patience.
Dr Betz ask for xray in March (5 months post surgery). I ll post it once done.

[Hamza]

Hello,

Now I reached 5 months post removing precice nail 2, inserting solid nail and lengthening approx 1 cm as LLD correction.
Now my femurs are perfectly equal but I still have 5 mm difference between tibias (3 mm in tibia + 2 mm in ankle due to the old surgery).
I feel full balance and comfortable by inserting a 3 mm insole. thanks GOD no more cutting and modifying shoes .
Last week I started walking for like 8 km and I am also able to run but sure for a short distance like 1 km.

Below is the link of my xray (5 months post surgery):

https://imgur.com/a/zm1EkmZ

Thanks God, Thanks Dr Betz.

I will post my new xray after 7 months.

[Movie]

congrats hamza, gladly the storm passed and you got yourself to a happy corrected point in your life. I wish you the best and fast healing.

[Hamza]

Xray after 10 month post surgery of removing failed precice nail 2 from right femur, inserting solid nail, acute lengthening of 9 mm for LLD correction.

https://imgur.com/rAHWlha

femurs are now perfectly equal and I feel much better overall when walking and running with no back pain. I am putting 5 mm insole now to make my tibias perfectly equal so knees and hip become perfectly leveled, I feel 100% balanced in running and walking while using this insole.
(originally i had 9 mm difference between femurs and 5 mm difference between tibias, so a total of 14 mm LLD)


Anybody advice me to think of surgically correction of this 5 mm LLD between tibias and get rid of the 5 mm insole ?
Is it possible to walk directly after tibia internal lengthening with solid nail like I did after femur surgery ?

[RealLostSoul]

Hey Hamza great to hear that your initial bad case got fixed! How is life nowadays?

I am interested if the hospital/nuvasive/rozbruch ever gave you any money back or offered anything in compensation?


ps

I never heard of any reputable and trustworthy doctors lengthening 4, 5 mm upon inserting nails

this is wrong. It's normal to have a couple of mm initial gap if you don't start lengthen right away. Paley does a quarter inch incision if I recall correctly (so about 6mm).

[curlyfella]

Also interested to hear what became of the refund/complications/lack of treatment?

This is the first time I've heard of a 6mm gap.

The bone does not consolidate unless it is compressed together and this is the first time I have ever heard of this for lengthening

Secondly - the acute gap - I've been told is never done - as it is such a risk as explained above and they gradually lengthen.

But who knows anymore - they all make up their own rules...........

[Hamza]

Thanks GOD i am back to normal, I am playing football and going to gym as before. bone is fully healed but nail is not removed yet due to covid19.

all my respect to the professional Dr Betz, the doctor, the father.

as for HSS they are respectful.
as for dr rozbruch, irresponsible of any complication, he lacks the most important thing in the medical profession, ethics.
as for nuvasive, definitely they do not respect their patients as they didn't even answer my emails and calls, unethical.

What i have now is exactly 7 mm difference between tibia's. Dr Betz can do the surgery for me but his advice is to better use an insole of 5 mm (as 7mm insole stress the toes a lot inside the shoes) and i am fine with 5 mm insole (but hate the fact that i am very dependent on it).

I do sports a lot and i walk barefoot on the beach a lot so i can feel the 7 mm big time when barefoot.
I limp a little bit when barefoot and i try to hide it as much as i can.

that is why i thought about surgically correcting the 7 mm LLD in tibia and get rid of any insole.
acute lengthening is much much easier than magnetic lengthening.

I do not see that anyone advice me to surgically correct the 7 mm LLD in tibia.

[PerfectBody]

The good news is that 7mm is just 7 days of lengthening. The bad news is that it's insanely expensive and painful. I hope your insurance can cover it man.

[Hamza]

The good news is that 7mm is just 7 days of lengthening. The bad news is that it's insanely expensive and painful. I hope your insurance can cover it man.

if decided, we ll go for acute lengthening, no need to use telescopic nail for just 7 mm.

have u done tibia lengthening before ?
Is it a successful surgery like femur lengthening ?
Femur acute lengthening of 9 mm using solid nail was not very hard and after 1 year i started playing sports normally.

[curlyfella]

if decided, we ll go for acute lengthening, no need to use telescopic nail for just 7 mm.

have u done tibia lengthening before ?
Is it a successful surgery like femur lengthening ?
Femur acute lengthening of 9 mm using solid nail was not very hard and after 1 year i started playing sports normally.

who would do the acute lenthening?
your case is the first case for this "acute lengthening"

For bone consolidation the bones must be pushed together and for lengthening slowly separated.
I have never heard any other doctor agree to do this acutely, that is not to say that it cannot be done
but it seems to not be done at all for the risks.
and it is a shame if it were not risky as limb could be equalized easily this way, much less costs, and no need for nails that can't bear weight.

Did you ever contact nuvasive of the new york doctors insurance to see if anything could be done?
Would they have treated you better if you lived in america?

[Hamza]

who would do the acute lenthening?
your case is the first case for this "acute lengthening"

For bone consolidation the bones must be pushed together and for lengthening slowly separated.
I have never heard any other doctor agree to do this acutely, that is not to say that it cannot be done
but it seems to not be done at all for the risks.
and it is a shame if it were not risky as limb could be equalized easily this way, much less costs, and no need for nails that can't bear weight.

Did you ever contact nuvasive of the new york doctors insurance to see if anything could be done?
Would they have treated you better if you lived in america?

acute lengthening can be done for small discrepancy only (<10 mm) otherwise u need a telescopic nail.
I did it for my right femur and as u said its much easier and u can walk on it from day 1.
I called nuvasive and i sent them an email and nobody answered at all.

[curlyfella]

Other than betz, did any other doctor offer to do the acute lengthening?

[Hamza]

Other than betz, did any other doctor offer to do the acute lengthening?

Yes many others as I have less than 1 cm difference.
For the 7 mm remaining in tibia, dr betz advised me not to surgically correct it as tibia is not as easy as femur correction.
He recommended to keep using insole for balancing.

I have a special case as i have mild charcot marie tooth disease (neuro muscular disease) and this 7 mm difference in tibia is due to a surgery (ankle fusion) i have done in 2003 to correct the cavus resulted from this disease. I lost the 7 mm after the correction surgery and i started putting insole to be able to walk and run properly.

[Hamza]

solid nail removed in 22/4/2022 (days ago) 2.4 years after nail insertion.
walk is much better without nail
1 day crutches usage only
full recovery seems to take 2 weeks max