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Author Topic: Lon tibia by Dr. Muharrem Inan  (Read 3250 times)

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ShaneIrish

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Lon tibia by Dr. Muharrem Inan
« on: July 11, 2021, 08:14:43 PM »

Kia ora everyone, since the surgery operated on my calves 53 days ago I have experienced a lot of physical therapies and gained 5.2 cm. I must state that Dr. Muharrem Inan is absolutely eligible to operate any methods of lengthening limbs. Also, I reckon I need to appreciate the agency AFA who offer the good physical therapy and accommodation services. I feel the doctor and the AFA shall be more known by more patients.

I did records of my health conditions and made videos every week, so I will put all them here by weekly records.

By the way, there are my information:

Gender: Male
Age: 22
Origina Height: 163.5cm
Nationality: China                                           
Method: Lon on Tibia
Goal:6cm
Date of Surgery: 2021/5/14
Starting Date of lengthening: 2021/5/20
E-mail: x2329414880@gmail.com
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LL2022

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Re: Lon tibia by Dr. Muharrem Inan
« Reply #1 on: July 19, 2021, 03:27:44 AM »

Hey man! Hope you are recovering fine, gor any updates for us?

I'm planning to do the LON tibias (5,5cm or slightly less) with either Dr Innan or Dr Buldu aswell. I contacted AFA and sofar they seem really nice and competent. What made you choose AFA and Dr. Innan over other Turkish Doctors, such as Dr Buldu? Did you organize and fix accomdation, food and other stuff yourself, since AFA does not include it in their packages

Lookimg forward to read about your recovery man
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Currently 168,5 cm - Goal -> 4,5 cm - 5 cm Tibias in Turkey

ShaneIrish

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Re: Lon tibia by Dr. Muharrem Inan
« Reply #2 on: July 19, 2021, 08:26:37 AM »

Yup, everything goes well and I will achieve my goal of 6-centimer distraction this week. AFA's services are truely more enthusiastic and qualified. Anyway, if you want to know more you can register an WhatsApp account msg me about that, some personal information should not be posted here (video-calling is prefferred).

Dr. Buldu's most cases are LON Femur, his most patiens come from USA and Europe. Tibia cases done by Buldu are much fewer. It seems that Buldu is good and skilled at operating LON Femur.

Dr Inan's techniques is a peak among Turkish orthopedic doctors, I didn't found any lengtheing cases he failed before. My Tibia x-rays photos are better than most patients in the forum.

AFA orgainise the accomdation, they found an hotel with generally good services and facility.
« Last Edit: July 19, 2021, 08:57:25 AM by ShaneIrish »
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Jokerhastowait2022

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Re: Lon tibia by Dr. Muharrem Inan
« Reply #3 on: July 19, 2021, 09:20:49 AM »

It would be nice if you could upload your recent x-ray so that we validate the authenticity of this diary.
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ShaneIrish

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Re: Lon tibia by Dr. Muharrem Inan
« Reply #4 on: July 20, 2021, 09:31:39 AM »




I did a collection of my X-ray photos so far. I resized the photos but being clear enough to see fixators and intraumedulary nails.
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LL2022

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Re: Lon tibia by Dr. Muharrem Inan
« Reply #5 on: July 20, 2021, 06:06:08 PM »

Hoe much did you pay for everything? Accomdation, the LON package, food etc? Any specific reason you choose Tibias over femur?

I hope you recover well! :)
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Currently 168,5 cm - Goal -> 4,5 cm - 5 cm Tibias in Turkey

Jokerhastowait2022

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Re: Lon tibia by Dr. Muharrem Inan
« Reply #6 on: July 20, 2021, 08:00:36 PM »

Thanks for the x-rays. Hope you have a smooth recovery!
Is there any reason he didn't fix the fibula to the tibia with a screw at the top to ensure knee stability? Many respectable surgeons say that's a must.
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Jokerhastowait2022

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Re: Lon tibia by Dr. Muharrem Inan
« Reply #7 on: July 21, 2021, 07:23:39 AM »

The screw I'm referring to is attached in here.
https://imgur.com/a/mEWG5IV
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ShaneIrish

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Re: Lon tibia by Dr. Muharrem Inan
« Reply #8 on: July 21, 2021, 08:53:06 PM »

     Hi Chasing the dream, I asked the AFA operator and she contacted Inan. The answer is that the screw fixes a fibula and a tibia is usually strong and long (longer than other screws fix the tibia with an intraumedullary nail), so it is likely the screw hurts the nerves and tendon under knees.
     And on the other hand, the fibula is not the bone bears body weight, rather tibia does. In my face to face appointment, Inan mentioned there  are other treatments to correct fibula in angulation and the fibula doesn't influnce patients while walking.
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ShaneIrish

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Re: Lon tibia by Dr. Muharrem Inan
« Reply #9 on: July 21, 2021, 09:22:00 PM »

The 1st Arrival Day at Instabul
      My arrival date at Istabul Airport is 10th May. I really want to complaint that WiFi didn’t work in the airport meanwhile I didn’t have a local SIM card (Buy a Vodafone card before your depature is needed), which means I have no ways to contact AFA. Fortunately, I appreciate an Indonesian guy shared his hotspot with me so I could phone the AFA team. It is so kind AFA offers a shuttle service, they directly bring patients to the hotel Bof Hotel Ataşehir (Haliç Sk, Tatlısu Mahallesi). The trip from the airport to the hotel needs 1 hour roughly.

Pre-Surgery Process and Time in Hospital
      Regularly, the surgery is arranged at 2-3 days after arrival and my surgery date is schedule on 14th May. And one day before the surgery, patients will go to the hospital Acibadem Saglik Grubu to have a PCR nucleic test,a blood test, a pre-surgery x-ray photo of the lower body and a face-face appointment with Dr.Innan. Particularly, during the appointment the maximum extension (normally <5cm on Tibia, <8cm on Femur) and method (LON or PRECISE 2) are determined and discussed. My goal is to lengthen my tibia up to 6 cm. Because my muscle is generally strong enough, therefore the goal is not constrained by Innan. (He is a conservative surgeon, you want 6cm, he proposes 5cm or 5.5cm ).  `
      After the surgery, I stayed in the hospital for 4 days (a care worker’s fee, food fees in hospital are included in the surgery cost). The memory in the hospital is fresh and unforgettable. I never came to a dream as my leg ached. The pain on pin sites was not intense but kept my mind awake, even I felt sleepy but could not fall asleep. Contramadals really help me to get through a hard time, but Dr.Innan is not willing to give patients more to avoid addiction of pain killers.
It is worthy mentioning that a friendly and responsible carer can help you a lot when unmovable. My carer looked after me for 10 days after leaving the hospital (the fees of 10 days are paid by patients). The expenses on a carer is expensive there, 100 USD per day. But it is true that my carer did most things for me ( laundry work, cooking, shopping .etc)
       


     Lengthening
      The lengthening work started from 20th May.
      During the whole lengthening process, I kept the distraction rate of 1mm per day until bone cracks were distracted up to 50mm. In the lengthening phase of the last 10mm, the rate is half reduced, 0.5mm per day. Totally 70 days are spent on lengthening time to achieve 6-centimeter distraction.
      The lengthening process goes generally successfully, no occurrences of nervous pain. Only terrible thing encountered is one pin site was infected and caused very intense and long-lasting pains. It seems like infections are very likely to happen even no showering for two months. It deserves to mention that do not take a shower before pin sites are completely healed. In other words, make wounds far away from water.
No ballerina happened. However, after distraction of calves exceeded 5 centimeters, I could feel greater tension forced my heels to get away from the ground. Importantly, wearing a pair of splint at night can effectively stop ballerina (put the splint on as long as you can). I usually wore that 3-4 hours on the bed since the surgery. (the situation of ballerina can be improved after the removal of fixators ). To prevent the occurrence of ballerina, I used a walker to hang out for at least 40 minutes everyday and wore the splint for full nights after 5cm (5-6 hours).

    Accommodation
As for the accommodation, AFA arranged all patients live in Bof Hotel Ataşehir. The fee of the accommodation varies, and is completely different depends on what type of rooms a patient live in. Currently the hotel provides two types of rooms, type one is a single room (having one bedroom), type two is a share room (having two bedrooms). Both the single room and the share room comprise a kitchen, a bathroom. The price now (2021/7) of the single room is 7500 TL per month (approx. 900 USD), the share room takes 8500 TL per month (approx. 1020 USD). It deserves to mention that, commonly two patients rent a share room together so that each one only pays half rent (510USD).

      Food
How to find food is a problem everyone here has to face. The AFA’s Package doesn’t include food. Regardless the hotel has a canteen and provide free breakfast and lunch to tourists, but none of us (Only Chinese patients) have that as Turkish food taste bad. Some guys order food on Yemeksepeti app (also daily necessities can be ordered), but the app doesn’t have English translation on restaurants’ menu, which means hard to precisely order the food you really want. Some patients only make a order from Burger King and Mcdonalds. For having formal Chinese meals, we ( totally six persons) hire a full-time cook and split the bill. 
Fees of food is largely depends on personal eating habit. If you order food from delivery app, the food expenses ranged from 100TL-130TL (360USD~468USD per month) each day, more or less. To me, roughly 400 USD is spent on food each month.


Surgery Cost

LON- 17,000 USD, and for 3 there is a group discount about 10% (This excludes the removal of intraumedullary nails)
Precise-39,690 USD, for those who do the 2nd surgery in meanwhile gets 2000 USD off. On internal methods.

P.S
-2000 USD as deposit should be prepared before patients’ arrival. It is certain that deposit will be refunded without any reasons if patients don’t come.

-AFA provides online appointments and tranlsation to patients before they come to Turkey. The online appointments are settled on Monday and Tursday only. 300 USD is paid for an appointment.

-The fee of removing nails is not included in surgery cost. The price of nails-removal is 4000 USD.
-Service charges of transaction are charged from patients' account.

The price includes below:
-Doctor consultation
-2 X-Rays
-All tests and examinations
-4-5days hospital stay
-Hospital&Surgery costs
-Caretaker fees (24hours during hospitalization)
-Meals during hospitalization
-All the transportation and airport pick up
-Medicines, splints, wheel chairs or walkers
-All basic personal strecthing equipment
- Splints for those who lengthen tibias
-CPM for all in hospitalization period
-Doctor routine consultations check ups
-IT band release (if needed)
-Fixator removal for LON patients
- Routine bandage changing and dressings for LON
- 5 days (5 sessions) of physiotherapy for every week covering the whole time till the end of Lengthening
-1 session hydrotherapy(water therapy)for Precice 2 patients per every week till the end of Lengthening

Physical Therapy

      On weekdays 2-hour physiotherapy is arranged for each patient (LON or P2), in a training room. The training room is located in the B3 floor of the hotel. Also, 1-hour water therapy is offered to patients with P2, 1 session per week. The team currently has two professional physiotherapist.
      The intensity of training is increased over time. The patients in initial time are required to do leg-rising, knee-bending and other simple exercises. A week later, they are required to wear sandbags, load ranged from 1 kg to 2 kg. As time goes by, they need to do exercises, such as squat, standing-up and walking without support (P2 patients are required to do walking or squat exercises in water).
      To patients who have done LON on tibia, stretching exercise and strength training are most concentrated on. As ankles and knees are very stiff, normally there are a lot of activities applied on the stiff body parts in the 1st week to help the patients to recover their sporty ability(move and swing ankle, bend knees). It is a must to note knee-bending exercise can cause pain and discomfort. It took me 7-8 days to recover and was able to make knees have full-motion exercises. Personally, pilates exercise can facilitate knee-recovery. More, using a stretch board and a stretch belt can largely ease tightness of tendon and muscle on calves. And never forget wearing splints before sleep, I knew some girls in Livinglifetaller got  ballerina just because they didn’t care about that (their heels were 2 or 3 cm away from the ground while walking).
      To patients with Precise 2, their training is somewhat different. They do cycling and spinning more, and physiotherapist tend to have more graston treatment om their legs to relax soft tissues. In the hydrotherapy, the patients are able to have walking and squat exercise completely free, no concerns on P2 nails’ hardness as buoyancy offsets most body weight.
     
The physical therapy include items as follows:
-Stretching exercise
-Strength training
-Pilates
-Electrical therapy
-Acupuncture
-Graston Technique
-Water therapy

    Contact
AFA operator: Ozlem
Emial: info@afacosmeticsurgery.com
phone&whatsapp: +90 533 318 86 68
website: www.afacosmeticsurgery.com
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ShaneIrish

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Re: Lon tibia by Dr. Muharrem Inan
« Reply #10 on: July 21, 2021, 09:32:02 PM »

The Livelifetaller and AFA both accommodate their patients in the same hotel. (AFA found the hotel first, and Live then move some patients here).  ???

That's fun to communicate with other patients. Never feel alone.

Toady the distraction has gone to 56.5mm.

HAVE A GOOD NIGHT.
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Jokerhastowait2022

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Re: Lon tibia by Dr. Muharrem Inan
« Reply #11 on: July 21, 2021, 10:16:06 PM »

Gerçekten o kadar detaylı bilgiler verdiniz ki gerçek bir hastanın tecrübelerini yansımıyor.  :)

Anyways, thanks for all the information! I guess the era of AFA vs Livelifetaller has officially begun.  ;D
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Jokerhastowait2022

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Re: Lon tibia by Dr. Muharrem Inan
« Reply #12 on: July 22, 2021, 10:45:28 AM »

     Hi Chasing the dream, I asked the AFA operator and she contacted Inan. The answer is that the screw fixes a fibula and a tibia is usually strong and long (longer than other screws fix the tibia with an intraumedullary nail), so it is likely the screw hurts the nerves and tendon under knees.
     And on the other hand, the fibula is not the bone bears body weight, rather tibia does. In my face to face appointment, Inan mentioned there  are other treatments to correct fibula in angulation and the fibula doesn't influnce patients while walking.

I found this post by Dr.Assyag: " 1)Failure to release the iliotibial band for a femur lengthening will lead to SEVERE abduction contracture, subluxation of the knee, knee flexion contractures.

2) failure to use blocking screws in a tibia lengthening will lead to a flexion /valgus deformity

3) failure to fix the proximal tibio-fibular joint while lengthening will lead to premature consolidation of the fibula regenerate, fibular head pull down, and TERRIBLE knee flexion contractures!
<
4) failure to recess the gastrocnemius.—> equinus ans knee contractures
5) failure to release the common peroneal nerve when symptoms of peroneal nerve paralysis or neuritis appear (i do it prophylacticslly for all tibia lengthenings)
6) failure to do percutaneous fasciotomies of the anterior and lateral compartment increases the risk of compartment syndrome.

finally 7) , failure to use rotational markers during the initial surgery leads to rotational deformities, knee pain, hip pain. That’s a noob move!"

If you look at the 3rd one, he emphasizes the importance of a proximal syndesmotic screw and its contribution to avoid complications.
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Arcon

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Re: Lon tibia by Dr. Muharrem Inan
« Reply #13 on: July 22, 2021, 11:11:39 AM »




I did a collection of my X-ray photos so far. I resized the photos but being clear enough to see fixators and intraumedulary nails.

What is this lysis of your bone around the  top and bottom pins of your ex-fix on the left leg on days 40 and 54??
Has your doctor said anything about this? Is it something similar to metal corrosion that we have seen with Stryde, or is there another explanation?
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ShaneIrish

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Re: Lon tibia by Dr. Muharrem Inan
« Reply #14 on: July 22, 2021, 09:07:42 PM »

3) failure to fix the proximal tibio-fibular joint while lengthening will lead to premature consolidation of the fibula regenerate, fibular head pull down, and TERRIBLE knee flexion contractures!
 
Hi Chasingthedream, I am sorry the question is professional and I cannot judge whether no use of a syndesmosis nail can cause negative influence on knees. But I don't perceive any physical pains or other problems while having flexion and extension movement by legs. No muscle contractures make the movement difficulty.

But I will do a collection of these questions.
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ShaneIrish

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Re: Lon tibia by Dr. Muharrem Inan
« Reply #15 on: July 22, 2021, 09:24:38 PM »

Hi Arcon, your question is very meaningful and I collect this with chasingthedream's. I have never heard LON patients encountered lysis of bones. The top pin site on the left leg is indeed surrounded by a dark area on tibia. This shall be not caused by metal erosion which happen on Stryde.















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KrP1

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Re: Lon tibia by Dr. Muharrem Inan
« Reply #16 on: July 29, 2021, 04:33:26 PM »

Hi. Could you post a photo of your legs ? it would be great to see the device. Cheers.
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Bob

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Re: Lon tibia by Dr. Muharrem Inan
« Reply #17 on: August 17, 2021, 11:49:44 AM »

Yup, everything goes well and I will achieve my goal of 6-centimer distraction this week. AFA's services are truely more enthusiastic and qualified. Anyway, if you want to know more you can register an WhatsApp account msg me about that, some personal information should not be posted here (video-calling is prefferred).

Dr. Buldu's most cases are LON Femur, his most patiens come from USA and Europe. Tibia cases done by Buldu are much fewer. It seems that Buldu is good and skilled at operating LON Femur.

Dr Inan's techniques is a peak among Turkish orthopedic doctors, I didn't found any lengtheing cases he failed before. My Tibia x-rays photos are better than most patients in the forum.

AFA orgainise the accomdation, they found an hotel with generally good services and facility.

How much does it cost for precise with Dr Inan?
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ShaneIrish

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Re: Lon tibia by Dr. Muharrem Inan
« Reply #18 on: August 19, 2021, 01:40:17 PM »

How much does it cost for precise with Dr Inan?

Precise-39,690 USD, for those who do the 2nd surgery in meanwhile gets 2000 USD off. On internal methods. Price for tibias and femurs are same.
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ShaneIrish

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Re: Lon tibia by Dr. Muharrem Inan
« Reply #19 on: August 19, 2021, 02:08:52 PM »

Hi. Could you post a photo of your legs ? it would be great to see the device. Cheers.


2021/5/30

« Last Edit: August 19, 2021, 02:52:01 PM by ShaneIrish »
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ShaneIrish

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Re: Lon tibia by Dr. Muharrem Inan
« Reply #20 on: August 19, 2021, 02:42:54 PM »



Now it has been 3 weeks since I removed my fixtors, what I am feeling about calves is that musles are softer than ever. Now, no aches I feel. Nevertheless daily exercisies and walking are kept, perfect controlling of body balance and squatting are troubling me. It is kinda like a toddler learn how to precisely master the space between each footstep and stumble slowly. It is worthy of noting that, after long-sitting my knees are always be stiff, so that some warm-up is necessary if knee-bending last for a long time.

At least I still need to use my walker now. To be conservative, this will not end until the middle of Sep. On account of slow bone healing, the doctor recommanded me to continue using walker until ditinct formation callus.


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Bob

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Re: Lon tibia by Dr. Muharrem Inan
« Reply #21 on: August 19, 2021, 02:51:58 PM »

Precise-39,690 USD, for those who do the 2nd surgery in meanwhile gets 2000 USD off. On internal methods. Price for tibias and femurs are same.

Thanks. Wish you the best.
I think the web address for AFA: http://www.drmuharreminan.com/en/ shown
in the Dr's list in this forum: http://www.limblengtheningforum.com/index.php?topic=592.0 is the old one. I believe AFA has a new website now if I'm correct.
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ShaneIrish

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Re: Lon tibia by Dr. Muharrem Inan
« Reply #22 on: August 19, 2021, 03:21:38 PM »

Summary about my tibia surgery:

My goal is completed, which I have gained 5.7cm and now been approx.170cm. If there is band from 0 to 10 to rate the surgery in terms of success, 7 is my evaluation. It is true that patients usually desire for the 2nd operation if the 1st one succeeded. Some years later I will go to Turkey again, and hope the limb lengthening industry is more reliable.

Physical unattractiveness can be solved by plastic surgery with ease. If short height hurt your confidence and self-esteem, the surgery is a way to find it back.
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more

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Re: Lon tibia by Dr. Muharrem Inan
« Reply #23 on: August 19, 2021, 05:48:38 PM »

Everything is Good . Your surgeon did a good Job. Focus on recovery
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Growing

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Re: Lon tibia by Dr. Muharrem Inan
« Reply #24 on: August 19, 2021, 06:12:01 PM »

Summary about my tibia surgery:

My goal is completed, which I have gained 5.7cm and now been approx.170cm. If there is band from 0 to 10 to rate the surgery in terms of success, 7 is my evaluation. It is true that patients usually desire for the 2nd operation if the 1st one succeeded. Some years later I will go to Turkey again, and hope the limb lengthening industry is more reliable.

Physical unattractiveness can be solved by plastic surgery with ease. If short height hurt your confidence and self-esteem, the surgery is a way to find it back.

Congrats.. Now you're on the other side. how was your pain level the entire time?
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Dark

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Re: Lon tibia by Dr. Muharrem Inan
« Reply #25 on: September 11, 2021, 10:22:13 PM »

Thanks Shane for such informative diary
Do you have an update of your recovery so far?
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willgettaller

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Re: Lon tibia by Dr. Muharrem Inan
« Reply #26 on: September 20, 2021, 06:07:40 PM »

hi̇ man, can you give us an update ?
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ShaneIrish

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Re: Lon tibia by Dr. Muharrem Inan
« Reply #27 on: September 23, 2021, 03:59:59 PM »

Hi everyone, I took the x-ray check on 20th and got photos, but hard to make electronic copies. Ultimately I post my x-ray photos here.



Apparently, outer side of fractured site has more bone celluses and left leg recovers faster than the left. I went to see an orthopaedist in Huaxi Hospital in China, his response is there are no problems and be careful to the wet floor and other places cause slip or trip. Also I sent the photos to Inan and waited for diagnosis, hope NOTHING wrong with my tibias.

The other thing I should mention is athleticism I own now. I can walk for 1h without any support on a regular street road at the speed 3~4km/h, though some passersby are able to recognise my legs are injured and they didn't suspect my excuse that an automobile accident causes temporary injuries on legs. Therefore I can resume my work now, this is a nice progress.

More, it's a nightmare for me to go down stairs. I consulted with a guy who had been removed fixtors six month ago, he was still troubling with coming down from a foot path of a overbridge.

My expection now is to regain the capacity of jogging and leapping by the end of this year, hope no accidents turn out.

Hope all you guys back to a normal life as soon as possible.
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Atomic

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Re: Lon tibia by Dr. Muharrem Inan
« Reply #28 on: September 23, 2021, 04:22:55 PM »

Congratulations. Your X-ray looks fine. The inner, outer, front and rear of the lengthening gap are usually consolidated at different speeds. Maybe it's because the circulation of these parts of the bone is different, I don't know. It is too early to evaluate stair climbing because ankle mobility and balance do not improve that quickly. Your walking distance is pretty good considering your recovery time. What about your nerve tension and calf muscles? Does your gait look normal?
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ShaneIrish

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Re: Lon tibia by Dr. Muharrem Inan
« Reply #29 on: September 23, 2021, 05:00:17 PM »

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aRealHamboi

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Re: Lon tibia by Dr. Muharrem Inan
« Reply #30 on: September 25, 2021, 01:57:11 AM »



Hey man, I hope you are doing well, I'm going for LON on tibias next week also albeit with a totally different surgeon.

I got to ask, what pain medications were you given?
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