Limb Lengthening Forum
Limb Lengthening Surgery => Limb Lengthening Patients Experiences => Topic started by: Hobbit99 on November 26, 2023, 12:49:13 PM
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Hello
I'm a 1,62cm guy from Rome, italy. Probably one of the shortest here. My goal is to reach 168cm (I know it's still short but it's more frequent among the population than 162, at least in central-southern italy)
So my goal is to lenghten 6 or 6.5 cm.
My doctors said that theoretically it's possible to reach 8 cm but it depents on the patient. It also suggested me to not go beyond 6, maximum 7 cm because I have short arms.
I had surgery with doctor Kirienko on october 11 of this year at Humanitas Research Hospital of Rozzano (Milan, Italy). The cost was 22k euros.
X-ray follow ups every 2 weeks at "Villa Stuart" in Rome.
Lenghtening started on october 16 a 1mm/day. I'm currently at 4cm and some minor bone callus startes showing up. The knee and ankle starts to oppose resistance. Especially knee extension is hard, but I reach full 180 degrees with stretching. I *should* reach 6 cm easily since there are still no clinically relevant contractures.
Only had on minor complication: slight procurvatum on left tibia. Doctors says it can happen because the gastrocnemius muscles push the tibia from behind. After the lenghtening ends, it will be easily solved by adjusting the proximal ring of the fixator by using hinges. No need for surgery thanks to the ilizarov apparatus.
Feel free to ask any question
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Are you using LON (lengthening over nail) or just fully externals?
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Just classic circular external frames, nothing internal.
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do you mind uploading your x-rays?
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sure, but I only have printed version from 2 weeks ago x-rays, at about 2,5cm and still no callus.
As soon as I get the new one printed from the clinic (I couldn't yesterday because I had another appointment later I will also post them)
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do you mind uploading your x-rays?
Here you go, these are from 2 weeks ago.
Sorry for the quality but by pc doesn't have a cd reader
You can see in the first image a slight procurvatum deformity. This should be fixed easily thanks to the hinges already attached to the fixator.
The cut is not clean probably because the didn't use the saw but rather the classic osteotome. His assistant told me that the saw generates too much heat.
Doctor says it's all good except for the procurvatum.
(https://s8d8.turboimg.net/t/95834464_photo_2023-11-26_16-11-24.jpg) (https://www.turboimagehost.com/p/95834464/photo_2023-11-26_16-11-24.jpg.html) (https://s8d8.turboimg.net/t/95834465_photo_2023-11-26_16-09-39.jpg) (https://www.turboimagehost.com/p/95834465/photo_2023-11-26_16-09-39.jpg.html) (https://s8d8.turboimg.net/t/95834466_photo_2023-11-26_16-12-18.jpg) (https://www.turboimagehost.com/p/95834466/photo_2023-11-26_16-12-18.jpg.html)
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Good luck on your recovery i hope everything goes well!
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Best of luck, this is the safest method but will take time.
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hey there any nerve pain yet? i got nerve pain at 4.5 cm . on my foot it was a burning sensation. i stopped lengthening at 5.5 cm couldnt take it anymore and got bored but should of continue. my neighbors did 8 cm . so if u got alot of time try aiming for 7.5 cm really. if u want to go femur then different story. alot of my doctor's patient did 7cm . on youtube too. they probably manage through the nerve pain but thats the only way to get more cm.
after removing the frames u feel really good but theres still a long road ahead of u. u still need learn to walk again.
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My main problem as of now is knee extension so i'm doing a lot of physical therapy (3 time a week + stretching when I'm alone). Sometimes I have burning sensation on my foot and ankle but it passes if I take tramadol.
I won't go over 7cm, probably neither over 6.5. My doctor said that in theory you can lenghten up to 8cm but it depends on the patient and I also have short arms so He discourages me to go over 6-7.
He says that from 5 to 6 is hard, 6 to 7 is harder and 7 to 8 really hard.
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i got short arms too. if i do my femurs i'll get to 175 cm . ill be average height . dream height but with short arms. it should be ok really. some guys do quadrillateral legthening and i doubt there arms are long enough. i would forget about the arms and grow the legs another cm if ur close to 170 cm u would feel more confident for sure.
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i got short arms too. if i do my femurs i'll get to 175 cm . ill be average height . dream height but with short arms. it should be ok really. some guys do quadrillateral legthening and i doubt there arms are long enough. i would forget about the arms and grow the legs another cm if ur close to 170 cm u would feel more confident for sure.
Proportions is not the only limit but also knee and ankle contractures which are commonly seen over 5cm.
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22k euro does not sound bad. Are you handling all of the lengthening and recovery on your own, and then visit Villa Stuart for PT and x-rays? Or did the doctor just give you exercises to do by yourself while lengthening?
I was just thinking it must be difficult alone especially with externals.
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I do the lengthening by myself by adjusting some bolts 4 time/day.
I go to villa stuart every 2 weeks (even if I’ve been operated in milan because the surgery was less expensive there) just for xrays and doctor appointments. The Doctor check my xrays, ability to stand and walk, ability to extend the knee and flex the ankle and so on.
You don’t need to do physical therapy at villa stuart, every physiotherapist should do the work.
I choose a physiotherapist that comes to my home 3 times/week as suggested by the doctor. I need to walk and bear weigt a lot with the help of the physiotherapist because weight bearing stimulates bone growth. I also need to do stretch my knee and ankles a lot, even when I’m alone.
My foot is always flexed to prevent equinous. My knee should always be flexed but I can’t bear the pain especially when trying to sleep at night, so I sleep with flexed legs. Doctor says it’s ok IF I do a lot of stretching during the day with and without the physiotherapist.
Edit: here you have a photo of my fixators
(https://s8d5.turboimg.net/t/95898610_58E7870D-4128-4D3E-8CA8-E0FBD7F3E24D.jpeg) (https://www.turboimagehost.com/p/95898610/58E7870D-4128-4D3E-8CA8-E0FBD7F3E24D.jpeg.html)
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Respect. That’s a tough thing to organize and do everything yourself especially with externals.
What do people like the physio and doctors at Villa Stuart say when they hear it is LL? Are they judgemental at all?
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When I go to villa stuart waiting for my appointment everyone has at least one fixators. Mostly in one leg. Two legs is mostly for cosmetic reasons ( height or deformities ). Just one patient asked me if I had a car accident. I said “no” and the conversation stopped there.
My classmates at university know about everything because I made some instagram stories. I don’t care what people think and I thought it could be interesting especially because we are medical students.
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Hey.
Can you describe your pins structure?
Like, how many pins, which type (thick or wire like), and where are they located?
I had three large ones on each side of the fracture, and two thin ones on both ends (around the ankle and near the knee).
And how are you feeling?
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I have 4 large pins for every leg. 2 near the knee and 2 near the ankle. And about 10 small pins, 5 near the knee and 5 near the ankle. My fixator only has 2 rings as you can see in the photo.
I'm feeling not very well because I'm stuck at home. It's more a psychological thing rather than pain. But it's a trade off to be taller.
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When I go to villa stuart waiting for my appointment everyone has at least one fixators. Mostly in one leg. Two legs is mostly for cosmetic reasons ( height or deformities ). Just one patient asked me if I had a car accident. I said “no” and the conversation stopped there.
My classmates at university know about everything because I made some instagram stories. I don’t care what people think and I thought it could be interesting especially because we are medical students.
Respect for your courage and ability to organize the whole thing yourself.
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Respect for your courage and ability to organize the whole thing yourself.
I thought this was the standard. Do many other surgeons offer to stay at the clinic for the whole lenthening process? I think it’s better to stay at home. At least I have my pc
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I thought this was the standard. Do many other surgeons offer to stay at the clinic for the whole lenthening process? I think it’s better to stay at home. At least I have my pc
Some people go home, often if they live nearby. But as far as I know people tend to stay in an accommodation offered by the surgeon close by the hospital where there are physios, food, other patients to socialize with etc.
The quality of these places vary of course.
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Got it. I think that is more common for surgeons or whole companies that focus on cosmetic ll with a lot of marketing and and a worldwide target.
My surgeon main job is treating various pathologies with the ilizarov and can also use it for cosmetic reasons.
I think it’s the same for other italian surgeons like catagni and pili.
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It's quite cheap, even externals are much cheaper here than in Poland. Is he experienced, do you have a website or a pge where I can read reviews. I assume he is an Ukrainian who works as a doctor in Milan, it's not a problem if he is experienced and does his job well tho.
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He's russian. He worked with Ilizarov himself in Kurgan.
He seems experienced.
I don't know about reviews. Try searching for his name on google/youtube or instagram
EDIT: 22k is a lot of money even for a surgery here in italy
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He's russian. He worked with Ilizarov himself in Kurgan.
He seems experienced.
I don't know about reviews. Try searching for his name on google/youtube or instagram
EDIT: 22k is a lot of money even for a surgery here in italy
Yes. I checked him, he is an experienced and legit one. You've mentioned that you returned to your home in Rome because you have your pc there. I want to ask you a question about it because I work in IT field as a programmer, do you think it's possible to do some programming microtasks like 2-4 hours a day?
How long will you wear these frames if you lengthen 6 cm?
Is it possible to live near him and checky by during the process, like renting a flat around the place that they did a surgery in milan?
Also I wish you good results and speed recovery!
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Yes you can program. I can study with my pc/ipad so can program. Be sure not having your knee always flexed. Do a lot of stretching.
I think ‘ll wear them for 8 months in total If I understood well, but it varies between patients.
I don’t know if it’s feasible to rent an apartment because rents in milan and near milan are very expensive. You should check some prices.
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are you going to bone consolidate with the frames on? i wonder why is that?
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Here you go, these are from 2 weeks ago.
Sorry for the quality but by pc doesn't have a cd reader
You can see in the first image a slight procurvatum deformity. This should be fixed easily thanks to the hinges already attached to the fixator.
The cut is not clean probably because the didn't use the saw but rather the classic osteotome. His assistant told me that the saw generates too much heat.
Doctor says it's all good except for the procurvatum.
(https://s8d8.turboimg.net/t/95834464_photo_2023-11-26_16-11-24.jpg) (https://www.turboimagehost.com/p/95834464/photo_2023-11-26_16-11-24.jpg.html) (https://s8d8.turboimg.net/t/95834465_photo_2023-11-26_16-09-39.jpg) (https://www.turboimagehost.com/p/95834465/photo_2023-11-26_16-09-39.jpg.html) (https://s8d8.turboimg.net/t/95834466_photo_2023-11-26_16-12-18.jpg) (https://www.turboimagehost.com/p/95834466/photo_2023-11-26_16-12-18.jpg.html)
I can't see any hinges... R U sure about the hinges?
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Yes, this is a hinge. (https://s8d5.turboimg.net/t/95922739_IMG_1905.jpeg) (https://www.turboimagehost.com/p/95922739/IMG_1905.jpeg.html)
There are 4 of them each leg. I don’t know if hinge is the correct term in english. In italian we call it
“snodo”
Don’t mind the dirt, it’s sticky from the patches.
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are you going to bone consolidate with the frames on? i wonder why is that?
What else could he do? We are talking about pure externals here.
For 6cm you will need close to 9 months if you have a normal consolidation. For 6.5cm you will need about 20 days more so closer to 10 months. 8 months is too optimistic especially for 6.5cm.
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What else could he do? We are talking about pure externals here.
For 6cm you will need close to 9 months if you have a normal consolidation. For 6.5cm you will need about 20 days more so closer to 10 months. 8 months is too optimistic especially for 6.5cm.
I don't exactly remember what he said but I think it was 2 months for lengthening + about 6 months for consolidation. For 6 cm. But I don't mind keeping my fixators on 1 or 2 months more.
What I care the most is start to walk better even with fixators on. He says the after lenghtening even if I need to correct the procurvatum I will have less pain and when the knee will be more straight I will be able to use crutches and later later on even walk without crutches.
For now just some little painful (but especially tiring) steps with a walker. Some day it's easier and I walk more, some day it's harder. I even climb up and dawn stairs with the help of the physiotherapist even if it's a bit painful but the doctor encourages me to weight bear because it stimulates bone growth.
EDIT: now at 4,3 cm I'm starting to have serious difficulties stretching the knee. It's painful and often stays flexed until I do a lot of painful stretching. I'll see what the doctor says next time. My physiotherapists told me I need to stretch more when I'm alone and probably in a week I'll be better.
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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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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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Are you still on 1 mm/ day?
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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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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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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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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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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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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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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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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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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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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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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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I wish the best for you my friend bye
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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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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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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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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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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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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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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 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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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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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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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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Do you have a correct contact e-mail to the company/him because he doesnt seem to answer my email.
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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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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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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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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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Another update. More problems start arising.
I have lost sensibility (or sensitivity?) in a small area of the skin around where the bone was broken. I hope it will return or at least it won't expand further.
Some times in that same area I have a sudden and intense pain of short duration, when I move the legs mostly but it's not really predictable.
Currently at 5cm
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i had like skin pain sometimes. kind of forgot what happen. when i ride the bike the next day my skin would react like a stretching of the skin and i would have pain there. it goes away like 3 days later.
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did you also experience loss of sensitivity on the skin?
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I had a Lon femur. There was a feeling of a cut at the bottom of the pins, it hurt a lot, and sometimes even though I had surgery on the femur, I had a burning sensation on the soles of my feet.
Don't worry too much about skin problems. It takes 2 to 3 days. However, if the pain and numbness are in the muscles, tendons and nerves, stop the extension. Because in Asian countries, the safe limit for the tibia is generally 5 cm. There are idiots in Turkey who make it 7 cm.
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I do not recommend 7 cm on the tibia, because it causes arthritis in the long run. I advise you to stay at 6 cm, arthritis will hurt you a lot in the long run.
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According to doctor Halil in Turkey, their height reached 7 centimeters, but there were also individuals with bad effects in the long term. You can find it on the forums. The safe limit is 6 cm.
There are other things doctors don't tell you: As you extend your leg, you lose your ability to run, you have difficulty climbing stairs, you have difficulty walking on hills, your weight-bearing capacity decreases. Doctors generally do not say these things to make money.
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According to doctor Halil in Turkey, their height reached 7 centimeters, but there were also individuals with bad effects in the long term. You can find it on the forums. The safe limit is 6 cm.
There are other things doctors don't tell you: As you extend your leg, you lose your ability to run, you have difficulty climbing stairs, you have difficulty walking on hills, your weight-bearing capacity decreases. Doctors generally do not say these things to make money.
I will ask the doctor about all this. He seems honest.
How much did you lengthen?
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lon 8.5 femur
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According to doctor Halil in Turkey, their height reached 7 centimeters, but there were also individuals with bad effects in the long term. You can find it on the forums. The safe limit is 6 cm.
There are other things doctors don't tell you: As you extend your leg, you lose your ability to run, you have difficulty climbing stairs, you have difficulty walking on hills, your weight-bearing capacity decreases. Doctors generally do not say these things to make money.
my doctor doesnt didnt really say anything he knows every patient wants to go 8 cm so he lets them. most of his patients does 6-8 cm. indian doctors on youtube also have patients lengthen to 7.5cm. i stopped after i had burning sensation and i also read on the forum about the limits and stuff. i sometimes feel i did way less than normal though
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Update: my knees are way better
They go full extension during PT without too much pain (I don't scream at least)
Still slightly bent when I walk
Burning pain from the left achille tendon
Also walking a lot better today
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Do you think the knee bending limitation was due to the procurvatum ?
Good to see you're recovering
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Brother , I understand you want to be tall, but please don't go to lengths that will harm yourself.
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Brother , I understand you want to be tall, but please don't go to lengths that will harm yourself.
But I need to trust the doctor. If the doctors evaluate me and says I can..
He already took the money I don’t think he says to add 1 cm more so that I give him more money.
I will ask him about the risks of doing another cm next time.
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Do you think the knee bending limitation was due to the procurvatum ?
Good to see you're recovering
No I don’t think it’s due to procurvatum because I have it in both legs. It’s for the calf muscles contracture
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Having more pin-related pain lately. Pins are leaving scars as they pull the skin. It usually goes away if I take FANS but I try not to take them too much because I heard they can interfere with bone healing.
Tramadol also helps.
Sleeping is not as bad as people describe, since I'm sleeping with bend legs. Cannot sleep with straight legs, it's like constant stretching. I try to compensate with more stretching and walking during the day as suggested by the doctor.
Sometimes I wake up during the night. 1 or 2 times per night. I take tramadol and/or ibuprofen and return to sleep.
I can also study during the day with enought concentration.
Seriously people on the internet seems to describe this surgery, especially with external frames, as something of infernal pain. It's not. It's infernal pain during physiotherapy sessions and maybe during the first 2 weeks, but most of the time it's slight pain or no pain with painkillers.
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nothing, I replied with the same message two times
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u got lucky u didnt feel burning pain. my right leg was always a problem for me. something wasnt right for me. decided to stop early. my nerves still dont feel right at my foot.
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I just had another appointment with the doctor. He said it’s going well, callus is forming, but feet are going into varus. I wrote the other day about noticing that my feet were rotate inward. Apparently it’s varus, but not equinus (ballerina). I will need to wear some elastic band to rotate my feet the opposite way and with time they will go normal again.
I asked about the callus compression when removing the frame. He said it’s not true, you don’t lose millimeters if the callus has healed completely.
He also said that it’s true that the xrays could show more mms than real, up to 10% more. Now it’s hard to say precisely but he told that, considering it’s showing 54mms, I should count around 52 real mms.
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Regarding how much cm we should go, he said that next time I will be around 6,5cm and depending how it goes he will decide if I can go up to 7 or stop at 6,5
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Stop at 6.5, what will an extra 0.5cm do? The risk and the longer down time isn't worth it.
6.5 is super for tibia in my opinion, if you go through it without any compromise of abilities.
I also had a bigger gain in x-ray than in real life.
I finally realized it's because of the frame, it makes your leg further away from the table, and that distance translate into a measurement error. If you do a leg length measurement with standing upright, you'll get the real measurement.
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Stop at 6.5, what will an extra 0.5cm do? The risk and the longer down time isn't worth it.
6.5 is super for tibia in my opinion, if you go through it without any compromise of abilities.
I also had a bigger gain in x-ray than in real life.
I finally realized it's because of the frame, it makes your leg further away from the table, and that distance translate into a measurement error. If you do a leg length measurement with standing upright, you'll get the real measurement.
I will add another 0,5 only if the doctor says there are no risks depending how this next cm goes.
Don’t care about the longer downtime, only about risks
Limby what was shown in your xray compared to real life?
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All the x-rays showed 4 cm but I never was able to see it in real life measurement... Until I did total leg length x-ray while standing upright and that one showed 3.5cm.
It's because previous x-rays laying down, the leg was raised from the table, I think something like 6-7 cm, because of the bulky frame. If the skin was flat on the table it would probably show the accurate measurement
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All the x-rays showed 4 cm but I never was able to see it in real life measurement... Until I did total leg length x-ray while standing upright and that one showed 3.5cm.
It's because previous x-rays laying down, the leg was raised from the table, I think something like 6-7 cm, because of the bulky frame. If the skin was flat on the table it would probably show the accurate measurement
So according to your experience in order to do real 6,5 cm I need to go to 7
edit: in another post you said your real gain was around 3cm
maybe you were not standing straight when measuring yourself?
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I think it depends on the x-ray technique. The bulkiness of the frame may also change a bit the situation.
But honestly I think it's for 0.5cm changes you shouldn't be concerned. If you did 6 cm so 0.5 less or more really doesn't change a thing. It's even less than gain you get by just changing your posture to appear taller in everyday situation
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Int the xray machine I lay down on a bed with a mechanical arms that the operator moves around, can also goes farther or closer. They lift my legs today with some pillows because I could not straighten the legs fully. It shows 54mm. Doctor says it’s maybe 52mm in reality. I’ll see next time.
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Hey man.
I hope your doing well.
I’m currently doing tibia deformity correction and also lengthening too. I’m either going to lengthen 1cm or 2cm. TSF frame. It’s via my country’s health care service, that’s why I can’t lengthen a lot.
I’d love to hear your opinion and also your Dr’s opinion on this.
How long would I need to stay in frames for, for either 1cm or 2cm?
I hate being in these frames, I can only imagine the will power you have to have lengthened 5cm and knowing that you’ll be in the frames for a long time. You’re a hero man.
But yeah, I’d love to hear your thoughts and also, would love to know what you are doing diet/supplement/devices/treatment wise to speed up your bone healing?
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Hey man.
I hope your doing well.
I’m currently doing tibia deformity correction and also lengthening too. I’m either going to lengthen 1cm or 2cm. TSF frame. It’s via my country’s health care service, that’s why I can’t lengthen a lot.
I’d love to hear your opinion and also your Dr’s opinion on this.
How long would I need to stay in frames for, for either 1cm or 2cm?
I hate being in these frames, I can only imagine the will power you have to have lengthened 5cm and knowing that you’ll be in the frames for a long time. You’re a hero man.
But yeah, I’d love to hear your thoughts and also, would love to know what you are doing diet/supplement/devices/treatment wise to speed up your bone healing?
You will need about 45 days for each cm. So 90 days for 2 cm.
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Hey man.
I hope your doing well.
I’m currently doing tibia deformity correction and also lengthening too. I’m either going to lengthen 1cm or 2cm. TSF frame. It’s via my country’s health care service, that’s why I can’t lengthen a lot.
I’d love to hear your opinion and also your Dr’s opinion on this.
How long would I need to stay in frames for, for either 1cm or 2cm?
I hate being in these frames, I can only imagine the will power you have to have lengthened 5cm and knowing that you’ll be in the frames for a long time. You’re a hero man.
But yeah, I’d love to hear your thoughts and also, would love to know what you are doing diet/supplement/devices/treatment wise to speed up your bone healing?
I need to have my frames on 8-9 months for 6cms. I think it’s about what body builder said
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You will need about 45 days for each cm. So 90 days for 2 cm.
Thank you so much. I asked this question to Dr. Assayag, and he said to expect to be in frames for 6 months. I asked him again, to make sure he didn’t misunderstand…again he said to expect 6 months.
I was so confused.
What do you guys think?
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I need to have my frames on 8-9 months for 6cms. I think it’s about what body builder said
I know this is a strange request, but if you get the chance, could you please ask your Dr this questions? How long to expect to be in TSF frames for a slight procurvatum deformity correction and 2cm lengthening? Male, 28 years old.
Thank you!
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I know this is a strange request, but if you get the chance, could you please ask your Dr this questions? How long to expect to be in TSF frames for a slight procurvatum deformity correction and 2cm lengthening? Male, 28 years old.
Thank you!
How well maybe with procurvatum it's longer? Anyway I also have procurvatum that I need to fix as soon as I finish lengthening.
It's a bit weird to ask my doctor how much time for another patient from another country cured by another doctor, but I'll see next time.
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How well maybe with procurvatum it's longer? Anyway I also have procurvatum that I need to fix as soon as I finish lengthening. It happened after I started lengthening as a complication.
It's a bit weird to ask my doctor how much time for another patient from another country cured by another doctor, but I'll see next time.
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Having excruciating pain when trying to move my right leg now. It’s from some pin sites. They’re clean, but that area and the muscleres around cannot be moved right now. So my right leg is paralyzed (I mean, the leg works, but it’s so painful to move). I hope it will go away, looks like a pin site inflammation.
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Having excruciating pain when trying to move my right leg now. It’s from some pin sites. They’re clean (mostly) but that area and the muscles around cannot be moved right now. So my right leg is paralyzed (I mean, the leg works, but it’s so painful to move). I hope it will go away, looks like a pin site inflammation.
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Thank you so much. I asked this question to Dr. Assayag, and he said to expect to be in frames for 6 months. I asked him again, to make sure he didn’t misunderstand…again he said to expect 6 months.
I was so confused.
What do you guys think?
For 2 cm? Of course not. If you have very slow consolidation you will need max 4 months for 2cm.
Hobbit99 clean the pin sites that hurt with disinfectant with something like betadine. Don't let it worsen. If it persists talk with your doctor to begin some oral antibiotics for 5-6 days and it will be fine. But you must not postpone it for many days
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For 2 cm? Of course not. If you have very slow consolidation you will need max 4 months for 2cm.
Hobbit99 clean the pin sites that hurt with disinfectant with something like betadine. Don't let it worsen. If it persists talk with your doctor to begin some oral antibiotics for 5-6 days and it will be fine. But you must not postpone it for many days
For now I’m putting betadine there. Let’s see how it goes
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u must be turning the screws and the pin is moving the bones and skin up . sometime my pin site hurts because there was a cut near it from turning alot.
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u must be turning the screws and the pin is moving the bones and skin up . sometime my pin site hurts because there was a cut near it from turning alot.
yea, some have big cuts and even some discharge but no pain. This one has just a small cut, no discharge and makes my leg impossible to move due to pain. The area of the skin around is very sensible when touching and hurts a lot.
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About those time calculation per cm...
Bodybuilder I actually relied on your opinion of 30-45 days per cm and I was shocked when my doc said 6 months for 3 cm...
I was actually so shocked that he started to doubt himself even...
But in actuality this is the surgeons experience.
I'm 7 months exactly after surgery and still not close to 100% full consolidation.
I was really down and worried for a long time with thoughts of delayed union, but after searching more I see that tibia can heal as much as 2 to 3 months per cm.
So when you're prepared for 4 months recovery, doing let's say 4cm and thinking it's a month /cm, when it's 2-2.5 months/cm, you suddenly get to 8 months. That's serious when you're preparing mentally for this journey.
I think it's important to know theres a range and variability with people's recovery and not to plan for specific outcome.
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About those time calculation per cm...
Bodybuilder I actually relied on your opinion of 30-45 days per cm and I was shocked when my doc said 6 months for 3 cm...
I was actually so shocked that he started to doubt himself even...
But in actuality this is the surgeons experience.
I'm 7 months exactly after surgery and still not close to 100% full consolidation.
I was really down and worried for a long time with thoughts of delayed union, but after searching more I see that tibia can heal as much as 2 to 3 months per cm.
So when you're prepared for 4 months recovery, doing let's say 4cm and thinking it's a month /cm, when it's 2-2.5 months/cm, you suddenly get to 8 months. That's serious when you're preparing mentally for this journey.
I think it's important to know theres a range and variability with people's recovery and not to plan for specific outcome.
What i hope is that consolidation phase will be easier even in frames. As of now I can’t walk more than 20 steps with the walker without feeling very tired.
As far as I know after finishing lengthening you will be in crutches and later on walk unassisted.
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About walking.
I was also told prior to surgery that the ilizarov can weight bare so you can be weight bearing very early.
I was getting off the bed and walk with crutches since day1 after surgery, and then some former patient told me I'll be able to put all weight on the leg in 3 months. And I was like "3 months?!" Hell no I'm gonna do it in two weeks maximum. In reality putting all your weight on a fractured leg isn't that simple. And it actually took me about 3+ months to be able to walk with one crutch and maybe 4.5-5 months to walk unassisted, very slowly and carefully.
So to summarize, take your time, do whatever is tolerated with a tad tendency to push yourself a little further through the pain, but not much more than this.
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About walking.
I was also told prior to surgery that the ilizarov can weight bare so you can be weight bearing very early.
I was getting off the bed and walk with crutches since day1 after surgery, and then some former patient told me I'll be able to put all weight on the leg in 3 months. And I was like "3 months?!" Hell no I'm gonna do it in two weeks maximum. In reality putting all your weight on a fractured leg isn't that simple. And it actually took me about 3+ months to be able to walk with one crutch and maybe 4.5-5 months to walk unassisted, very slowly and carefully.
So to summarize, take your time, do whatever is tolerated with a tad tendency to push yourself a little further through the pain, but not much more than this.
My doctor advised me to stand and walk as much as I possible because it helps callus formation.
I’m a bit scared of losing height because someone in this forum said that at the end they were even 1,5 cm shorter than expected
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About those time calculation per cm...
Bodybuilder I actually relied on your opinion of 30-45 days per cm and I was shocked when my doc said 6 months for 3 cm...
I was actually so shocked that he started to doubt himself even...
But in actuality this is the surgeons experience.
I'm 7 months exactly after surgery and still not close to 100% full consolidation.
I was really down and worried for a long time with thoughts of delayed union, but after searching more I see that tibia can heal as much as 2 to 3 months per cm.
So when you're prepared for 4 months recovery, doing let's say 4cm and thinking it's a month /cm, when it's 2-2.5 months/cm, you suddenly get to 8 months. That's serious when you're preparing mentally for this journey.
I think it's important to know theres a range and variability with people's recovery and not to plan for specific outcome.
I needed less than 11 months for 7.5cm although I kept the frames one month more to not lose even 1mm. So for 7,5 cm I needed 11 months which means exactly days for each cm. And the more you lengthen you need a little.more time.for each cm. If I lengthened just 2cm I don't thunk I would have needed more than 80 days.
But I was young (23yo) and very healthy however I never used any vitamin d or calcium supplements and all these. Just normal food.
Anyway, about 45-50 days for each cm is the average. More than 60 days for a cm means a delayed consolidation but still you will be fine in the end, just be patient. But more than 60cm per cm is problematic. Somethimg is wrong if someome needs that much time.
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Consolidation is much easier than lengthening as your leg gets to relax but pls don’t go further than 6cm. Some drs are patient pleasers and don’t stop them even when it’s necessary, it’s not about having been paid already. I’ve did 4.5 and am happy with it. The patients I know who did 6cm have a much longer & tougher recovery and are advised a calf release to relax the muscle. Think about your future & functionality. No point in being tall if u lose good function
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Consolidation is much easier than lengthening as your leg gets to relax but pls don’t go further than 6cm. Some drs are patient pleasers and don’t stop them even when it’s necessary, it’s not about having been paid already. I’ve did 4.5 and am happy with it. The patients I know who did 6cm have a much longer & tougher recovery and are advised a calf release to relax the muscle. Think about your future & functionality. No point in being tall if u lose good function
If my recovery will be longer I don’t care. I only care about permanent damages.
For now my doctor says I’m doing well. I have a knee contracture but it’s not clinically severe and it should go away with physiotherapy.
Next time i see my doctor I will be around 6,5 cm. He said I can go to 7 depending how well he will find me next time.
I know it could be risky, but I trust my doctor can predict/fix complications and also everything beyond 5cm if risky. I need to take some risks and also trust my doctor. If he says I can go to 7 than he should be right. If I do less because someone in a forum told me it’s risky than I could have regrets later on.
Also what if 6 cm in realy is 1cm less, about 5cm like some people reported? Like sweden or lumiere. I would be 167 with only real 5cms. With 7cms I’m sure I will be at least 168 like my father, my target height.
Remember that I have a very bad starting height, below the 3° percentile.
Need to trusts the expers and take some risks.
edit: in theory my doctors let patients lengthen tibias up to 8cms. But in my case I was advised against. Always suggested 6-7. I don’t think he’s a pleaser
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regarding femurs
more than a couple people asked in my pms if Kirienko also does femurs.
I know for sure he can lengthen femurs, but I don’t know if he does it for cosmetic reasons.
There are some treatments example on this website. One about a girl with a discrepancy in the femurs that got lengthened with precice nail and another with the ilizarov apparatus mounted to the femur.
Regarding cosmetic lengthenings there are 3-4 examples of patients all lengthened with ilizarov on tibia by 5-8 cms.
So if you’re interested in femurs I think you should ask him directly by mail. Also ask him which method he uses for cosmetic femurs because I feel that 2 ilizarov frames on femurs could be very hard to manage for the patient.
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I'm starting to walk tip toes. Almost 6cm.
Pain during physiotherapy is really bad.
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What pain are you having?
Is it muscle pain?
If it's muscle pain of the sort of tightness like a sore muscle after workout, when stretched, than it most probably temporary.
It's a bummer to be worried of every pain that it might be a complication and permanent, but 99 of the cases is a temporary pain which will subside once you stop lengthening...
Maybe slow down the lengthening phase or take some days off..
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What pain are you having?
Is it muscle pain?
If it's muscle pain of the sort of tightness like a sore muscle after workout, when stretched, than it most probably temporary.
It's a bummer to be worried of every pain that it might be a complication and permanent, but 99 of the cases is a temporary pain which will subside once you stop lengthening...
Maybe slow down the lengthening phase or take some days off..
I'm not really sure how to know what tipe of pain it is
When you take a break, does pain stops immediately the day after or maybe a week later or something? So to stop/reduce pain for how many days should I stop the lengthening?
Pain is just when I stretch just to clarify. When my pt stretches my knee.
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I would address that as the normal expected "good" pain.
Still I wouldn't worry about stopping lengthening for few days to let the soft tissue adapt. It takes about 3 weeks I thin in minimal to get to the risk of early consolidation.
Still, ask your doc to make sure..
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I turned 6,8 but Dr. Kirienko today said it's closer to 6,2 or 6 cm in reality (don't know why). I will lengthen another 0,5cm (till the 27) and then I will only turn the posterior screws to fix the procurvatum on both legs. He says I will be around 6.5 cm I should keep that gain, with no lose during consolidation phase nor after fixator removal.
I'm having much more pain lately and standing is hard as the first days, probably because I'm about to reach my limit.
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Finally finished with the lengthening phase. Tomorrow I will start the procurvatum correction.
Pain has become really intense on my right leg. Sometimes even little movements make me scream from pain. I need to stand completely still some times to not let that horrible pain kick in. I think it’s nerve pain. It also happened on my left leg at around 4 cm mark but then it went away.
I hope the correction is not as painful since I just need to turn the posterior screws to change the angle of the proximal ring of the fixator.
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Stay strong dude, the hard part is over. Now you just need time and some pt.and you will be ready to enjoy your new height.
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i remember my fibula had really intense pain in the beginning because it was broken. but it eventually went away with time passing by.
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Hobbit did your doc tell you to go 1 mm/day for the entire 6.8 cm lengthening?
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Hobbit did your doc tell you to go 1 mm/day for the entire 6.8 cm lengthening?
yes
73 turns at 1mm/day
for around 6.5 cm gain according to my doctor
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i remember my fibula had really intense pain in the beginning because it was broken. but it eventually went away with time passing by.
well of course it’s broken
even the tibia it’s broken
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yes
73 turns at 1mm/day
for around 6.5 cm gain according to my doctor
Interesting. I wonder why he didnt recommend slowing down after the first couple of centimeters which I think from other diaries is more normal.
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Interesting. I wonder why he didnt recommend slowing down after the first couple of centimeters which I think from other diaries is more normal.
yeah, I don’t know
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I'm a bit depressed because I still can't walk even with the walker. The pain is slowing going away but the knee is bent and It's really hard to walk with the point of your feet and not fall. I hope this will go away or at least get better in 1-2 months.
This and next week I'll do pt every day because I also got covid and didn't stretch/excercise enough these days.
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Hey hobbit. I hope your doing well.
Since your doing purely external with illirarov I wanted to ask you:
How much walking do you do a day? How has this changed the more you lengthened?
Do you use a walker or crutches?
What exercises do you do for your physiotherapy? I will really appreciate it if you can write down all the things you do for your physio. For example, what exercises and what stretches.
Also how many times a day do you do your excercises?
And finally, are you basically in bed the whole day?
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Hey hobbit. I hope your doing well.
Since your doing purely external with illirarov I wanted to ask you:
How much walking do you do a day? How has this changed the more you lengthened?
Do you use a walker or crutches?
What exercises do you do for your physiotherapy? I will really appreciate it if you can write down all the things you do for your physio. For example, what exercises and what stretches.
Also how many times a day do you do your excercises?
And finally, are you basically in bed the whole day?
Hi, I think it's a bit better but I'm still on the point of my feet (ballerina? bent knee? don't know exactly the cause) so it's really tiring, 2-4 steps and I need to sit down because my feet hurts. I sent the doctor some photos and he said I need to have patience until the muscle will give up and both the knee and feet will go straight again.
I'm using a walker since the day after the surgery. Initially I could walk around 20 steps (3 days after surgery). Then when I started the lengthening I could not walk more than 1-2 steps for about 2 weeks because intense pain on my leg. Between 3 and 4 cm I could easily walk 20-50 steps and even climb some stairs. Around the 5 cm mark I was walking with my feet slightly on their points but it was still doable. Now at 7,3 cm (6,5 real gain according to the doctor) walking is really hard as I described before.
I'm basically on the bed/couch/chair the whole day
For physiotherapy the number 1 thing is to straighten bot the feet and the knee (feet are ballerina AND varus). The knee especially hurts a lot to the point that I scream during the stretching. Initially, 1-2 week after surgery, I needed to stand up and walk a lot to stimulate initial bone callus formation, even if it hurts a lot (I mean a lot). Now we stretch a lot the knee, the ankle and when I stand up we try to bring the heels down as much as I can.
Still no crutches, only walker. Around 3-4 cms I could remove my hands from the walker and stand a bit unassisted (but not walking). Now it's not possible anymore because my feet do not touch the ground completely.
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Hi all
I had another appointment with the doctor. The procurvatum tibia deformity is only slightly better. It appears that the calf muscles are too big and push the tibia anteriorly, so we cannot procede with the correction until the calf muscles will be more relaxed. So the dr, told me to stop turning completely with the fixator (i was only turning the posterior rods to fix the misalignment since december 28). At least for 1 month, so until the next appointment, to give time to the muscles to relax so the the tibia will be slightly pushed posteriorly as well, than the next time we’ll do some “mini adjusments” for the “final correction”. This had me a bit worried, because i fear premature consolidation during this month.
I feel that my knee is slightly better since i stopped turning, but my feet are still bad. I have equinovarus feet, so they’re bot equinous and varus. I put all my weight on the point of my feet (equinous) and on the external border (varus).
The equinous, or ballerina as it’s called on this forum, is what really prevents me from walking. My heels do not touch the ground and the points of my feet hurts. I cannot remove my hans from the walker or I fall. I cannot even move the walker forward (no wheel) because of this. So I basically let someone pull the walker and I do 3-4 steps before feeling really tired on my upper body and in need to sit down to rest a bit, than other 3-4 steps.
Also i cannot stand straight, otherwise I tend to fall.
I’m feeling the worst since the surgery because I can’t walk like this, and if I can’t walk I cannot properly stretch the achille tendon.
I think my heels are 3-4 cm above the ground.
the doctor said this (equinous and varus) will go away with time and not to worry about. He also said I can use lifts to walk, but still have not tried. I fear lifts prevent me to fight ballerina?
I really hope the doctors are right and are not just trying to keep me calm. I will follow instructions and hope for the best.
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Stay strong and keep us updated.
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If I were you I would have serious concerns. Just don't be alarmed but be diligent. I would believe the main reason you got all these problems it's because you over-extended your tibias. In my opinion for tibias anything above the 4 to 5 cm range it's a big NO. I still don't understand why some Doctors suggest going over 4-5 cm. It makes no sense. If you do a quick research, the very best Drs. (Paley, Lee) they would never EVER suggest doing more than 5cm for tibias and a max of 8cm for femurs. There is a reason for that.
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If I were you I would have serious concerns. Just don't be alarmed but be diligent. I would believe the main reason you got all these problems it's because you over-extended your tibias. In my opinion for tibias anything above the 4 to 5 cm range it's a big NO. I still don't understand why some Doctors suggest going over 4-5 cm. It makes no sense. If you do a quick research, the very best Drs. (Paley, Lee) they would never EVER suggest doing more than 5cm for tibias and a max of 8cm for femurs. There is a reason for that.
Lee does 7 cm does he not? At least I think I remember from his paper on recovery of his patients the average amount lengthened was 6 or 7 cm.
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Most LLers can do 6.5cm on tibias without many issues. At least no more than 8cm on femurs.
4-5cm on tibias as a safety limit is a joke.
Bf of 3-4cm will become better as you start walking. Use lifts in the begining and with time remove 1cm till you don't need them. Even having always 1-2cm lifts is not a big deal to help you walk easier.
After all most of us before LL used much more than 2cm lifts.
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If I were you I would have serious concerns. Just don't be alarmed but be diligent. I would believe the main reason you got all these problems it's because you over-extended your tibias. In my opinion for tibias anything above the 4 to 5 cm range it's a big NO. I still don't understand why some Doctors suggest going over 4-5 cm. It makes no sense. If you do a quick research, the very best Drs. (Paley, Lee) they would never EVER suggest doing more than 5cm for tibias and a max of 8cm for femurs. There is a reason for that.
I definitely reached my limit. Every doctor suggests different amount of lengthening. I did what my doctor suggested and not more.
As far as I know only paley suggests maximum 5 (but he did more, as you can understand from his article from the 90s: “problem, obstacles and complications of limb lengthening by the ilizarov technique”) https://www.researchgate.net/publication/20751607_Problems_Obstacles_and_Complications_of_Limb_Lengthening_by_the_Ilizarov_Technique
I just hope the ballerina feet will go away as I’m being told and that atl surgery is “rarely” necessary
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Most LLers can do 6.5cm on tibias without many issues. At least no more than 8cm on femurs.
4-5cm on tibias as a safety limit is a joke.
Bf of 3-4cm will become better as you start walking. Use lifts in the begining and with time remove 1cm till you don't need them. Even having always 1-2cm lifts is not a big deal to help you walk easier.
After all most of us before LL used much more than 2cm lifts.
never used lifts
I will buy some 4 cm ones soon
even tho I prefer I won’t need them in the future, and that my heels will just go flat on the groung so I can easily walk barefoot
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Lee does 7 cm does he not? At least I think I remember from his paper on recovery of his patients the average amount lengthened was 6 or 7 cm.
donghoon lee? as far as I know, yes he goes beyond 6 cm, up to 7 and maybe more? It depends on the patient. Some can achieve greater amount of lengthening without (serious) complications, other may need to stop much sooner
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Most LLers can do 6.5cm on tibias without many issues. At least no more than 8cm on femurs.
4-5cm on tibias as a safety limit is a joke.
Bf of 3-4cm will become better as you start walking. Use lifts in the begining and with time remove 1cm till you don't need them. Even having always 1-2cm lifts is not a big deal to help you walk easier.
After all most of us before LL used much more than 2cm lifts.
>BS
>The best doctor in the field (Paley) say 5cm it's the limit
>Some anon on the internet say its BS.
Who should I believe?
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donghoon lee? as far as I know, yes he goes beyond 6 cm, up to 7 and maybe more? It depends on the patient. Some can achieve greater amount of lengthening without (serious) complications, other may need to stop much sooner
I don't remember where I read he stated 5cm its the safest lenght for tibias. But again, Paley is very clear with this. I would trust his word more than internet randoms or not so well known surgeons.
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I don't remember where I read he stated 5cm its the safest lenght for tibias. But again, Paley is very clear with this. I would trust his word more than internet randoms or not so well known surgeons.
It’s probably true that 5 cm is safer than 6. Like 3 is safer than 5. This does not mean that more than 5 is not possible if your body lets you. https://youtu.be/HDBkSAFVe3A?si=7MhIkmIvYFQcTdI6
I know that paley is very strict with 5cm lately and I know he’s considered the best, but there are many experienced surgeons with different opinion on this.
I did my research, i know that in medicine there are often different opinions that are equally true. We don’t have a peer review paper that states anything beyond 5 cm you are crippled.
I don’t think it’s my fault just because I didn’t follow paley recommendations or I didn’t choose to go to paley.
Anyway, I’ll wait for my feet to return to normal and even if they do not, ballerina foot is fixable in some ways. But the doctor said it goes away by itself in most cases.
What worries me more is the procurvatum/misaligment. I hope to see that completely fixed next month.
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It’s probably true that 5 cm is safer than 6. Like 3 is safer than 5. This does not mean that more than 5 is not possible if your body lets you. https://youtu.be/HDBkSAFVe3A?si=7MhIkmIvYFQcTdI6
I know that paley is very strict with 5cm lately and I know he’s considered the best, but there are many experienced surgeons with different opinion on this.
I did my research, i know that in medicine there are often different opinions that are equally true. We don’t have a peer review paper that states anything beyond 5 cm you are crippled.
I don’t think it’s my fault just because I didn’t follow paley recommendations or I didn’t choose to go to paley.
Anyway, I’ll wait for my feet to return to normal and even if they do not, ballerina foot is fixable in some ways. But the doctor said it goes away by itself in most cases.
What worries me more is the procurvatum/misaligment. I hope to see that completely fixed next month.
Of course is possible going for more than 5cm. But I don't believe its worth it. The risk-reward ratio its just too dangerous. Even if it isn't yet a peer review paper its your health what you are putting ar risk (Im not lecturing you, it's your health and not my problem).
What I don't like about all these doctors is they suggest patients to go for these dangerous limits. I don't think is ethic. I much rather hear and believe what Paley says.
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Of course is possible going for more than 5cm. But I don't believe its worth it. The risk-reward ratio its just too dangerous. Even if it isn't yet a peer review paper its your health what you are putting ar risk (Im not lecturing you, it's your health and not my problem).
What I don't like about all these doctors is they suggest patients to go for these dangerous limits. I don't think is ethic. I much rather hear and believe what Paley says.
This surgery is risky
of course 4 cm is safe, but not worth 20k euros and you need to consider you can do this once in your life probably
when you are short, every cm matters and every cm is an added risk
these are not easy decisions to make and I’m not ignorant, I did my research and I accepted the risks. Contractures are fixable by pt or surgery. We’re not talking about the risk of an amputation here, but things that are fixable.
Now, probably it’s me being a bit paranoid, but I feel I’m being judged (or yes, lectured).
It’s already hard as it is now so please understand
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This surgery is risky
of course 4 cm is safe, but not worth 20k euros and you need to consider you can do this once in your life probably
when you are short, every cm matters and every cm is an added risk
these are not easy decisions to make and I’m not ignorant, I did my research and I accepted the risks. Contractures are fixable by pt or surgery. We’re not talking about the risk of an amputation here, but things that are fixable.
Now, probably it’s me being a bit paranoid, but I feel I’m being judged (or yes, lectured).
It’s already hard as it is now so please understand
Don't get me wrong I'm not in any way judging you or trying to lecture you on anything, I just hope the best for your recovery. It just makes me really mad when doctors suggest to patients going for more than the general accepted safe limits. I do understand every centimeter could be potentially life changing but I don't believe it's worth it. Its certainly a risky surgery, why to put even more risk factors on it? I hope the very best for your recovery
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thanks
but there is no general accepted safe limits
every one has slightly different opinions on this
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Kind of worried about you.. no update since two weeks.. hope you are getting better.. let us know you are okay
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Same I would like to know if everything is ok.
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Hello
I tried to join the forum but it was offline for some reason? Now is back up.
Things are not going well with my equinus. He says he has seen worse cases that recovered, but I need to keep a tight shoe that pushes my feet in dorsiflection, day and night. I can't stand the pain from I think some callouses that formed on the soles of my feet, but he said that If I can't do it he will need to to ATL. He prefers not to do ATL because he says it's "traumatic"?
I told him maybe it's better to go back 1cm to when my equinus started but was somewhat manageable, but he again said it's better to try with the shoe and a lot of standing since usually people recover from this.
In this last month I saw some progress. I can again walk a bit every day, but it's exhausting because of the equinus. Wearing a 5cm lifts helps but not too much and my PT says that if I use lifts then my achille tendon will never stretch.
Tomorrow I will have another appointment. I think he will finally tell me if I need to keep pushing with rehab or I need to do ATL.
If I need to do ATL I hope it will go well and not like some users on this forum.
I will let you know.
If I manage to fix the equinus without surgery would be fantastic but it's hard, really hard. Basically you can't stand with both ballerina feet. I thought you could before the surgery, reading this forum, but it's not my case. Standing up and walking without the full support of your feet is the hardest thing so far.
EDIT: at least it looks like there is not more procurvatum. Legs look straight from the rx. Bone callus is forming well.
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Hello
I tried to join the forum but it was offline for some reason? Now is back up.
Things are not going well with my equinus. He says he has seen worse cases that recovered, but I need to keep a tight shoe that pushes my feet in dorsiflection, day and night. I can't stand the pain from I think some callouses that formed on the soles of my feet, but he said that If I can't do it he will need to to ATL. He prefers not to do ATL because he says it's "traumatic"?
I told him maybe it's better to go back 1cm to when my equinus started but was somewhat manageable, but he again said it's better to try with the shoe and a lot of standing since usually people recover from this.
In this last month I saw some progress. I can again walk a bit every day, but it's exhausting because of the equinus. Wearing a 5cm lifts helps but not too much and my PT says that if I use lifts then my achille tendon will never stretch.
Tomorrow I will have another appointment. I think he will finally tell me if I need to keep pushing with rehab or I need to do ATL.
If I need to do ATL I hope it will go well and not like some users on this forum.
I will let you know.
If I manage to fix the equinus without surgery would be fantastic but it's hard, really hard. Basically you can't stand with both ballerina feet. I thought you could before the surgery, reading this forum, but it's not my case. Standing up and walking without the full support of your feet is the hardest thing so far.
EDIT: at least it looks like there is not more procurvatum. Legs look straight from the rx. Bone callus is forming well.
Sei una cazzo di roccia, si può tornare indietro con l'allungamento?
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Sei una cazzo di roccia, si può tornare indietro con l'allungamento?
Si si può ma me lo ha sconsigliato.
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I'm happy to say that the doctor said my feet are much better now. He says I won't have to do ATL because my soft tissues are very flexible.
He said I need a bit of more effort and patience (but he didn't say how much time) and I will recover from ballerina without surgery.
For now, he said I need to walk with high shoes and lifts. This will relax the posterior muscles of the leg and somewhat will also help to stretch the achille tendon even if I can't understand why.
Until now I didn't use lifts because my pt said that with lifts my tendon would never stretch. The doctor said that walking on tip toes is actually worse because it worsen the contracture (?). I didn't understand the reasoning, but I'll trust and follow what he says no matter what my pt thinks.
I'll buy some tall shoes and start to walk with them and hope that I will be back to normal in some months.