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[Hobbit99]

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

[overandover]

Are you using LON (lengthening over nail) or just fully externals?

[Hobbit99]

Just classic circular external frames, nothing internal.

[saltedchocolate]

do you mind uploading your x-rays?

[Hobbit99]

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)

[Hobbit99]

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.

 

[GreenGoblin]

Good luck on your recovery i hope everything goes well!

[overandover]

Best of luck, this is the safest method but will take time.

[Beemer m3]

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.

[Hobbit99]

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.

[Beemer m3]

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.

[Hobbit99]

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.

[TheDream]

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.

[Hobbit99]

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

 

[TheDream]

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?

[Hobbit99]

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.

[limby101]

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?

[Hobbit99]

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.

[TheDream]

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.

[Hobbit99]

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

[TheDream]

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.

[Hobbit99]

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.

[lucindaris]

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.

[Hobbit99]

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

[lucindaris]

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!

[Hobbit99]

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.

[Beemer m3]

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

[Marie_Bard]

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.

 

I can't see any hinges... R U sure about the hinges?

[Hobbit99]

Yes, this is a hinge. 

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.

[Body Builder]

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.

[Hobbit99]

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.