Limb Lengthening Forum

Limb Lengthening Surgery => Limb Lengthening Discussions => Topic started by: Bob on January 16, 2022, 10:40:42 PM

Title: Pure external TSF tibia and walking
Post by: Bob on January 16, 2022, 10:40:42 PM
When you have tibia surgery using pure circular external device like TSF can you walk and weight bear 100% without walker or crutches when you are finish with lengthening? 
Title: Re: Pure external TSF tibia and walking
Post by: Medium Drink Of Water on January 16, 2022, 11:16:42 PM
No.  You have to wait for the bones to consolidate.
Title: Re: Pure external TSF tibia and walking
Post by: Bob on January 16, 2022, 11:32:10 PM
No.  You have to wait for the bones to consolidate.

Thanks.
Title: Re: Pure external TSF tibia and walking
Post by: zaozari on February 02, 2022, 03:01:17 PM
I've never used crutches but in each step, don't we put at least part of the body weight on one leg and the rest on the crutch?
Or are we totally "forbidden" to touch the ground with the foot on that side also, and thus need to walk doing kind of little jumps with full support of arms and crutches exclusively?
Title: Re: Pure external TSF tibia and walking
Post by: ReadRothbard on February 02, 2022, 04:09:46 PM
No.  You have to wait for the bones to consolidate.

Don't you start walking roughly mid-way through consolidation?
Title: Re: Pure external TSF tibia and walking
Post by: Medium Drink Of Water on February 02, 2022, 04:30:28 PM
Don't you start walking roughly mid-way through consolidation?

You can start walking shortly after surgery.  You don't have to wait until you're done turning the knobs to walk.  Sorry if I misunderstood the 1st question.
Title: Re: Pure external TSF tibia and walking
Post by: ReadRothbard on February 02, 2022, 05:07:34 PM
You can start walking shortly after surgery.  You don't have to wait until you're done turning the knobs to walk.  Sorry if I misunderstood the 1st question.

That's what I thought. I was under the impression externals were fully weight-bearing immediately after surgery, and I think you start walking without support a month or two into consolidation (I could be wrong here).
Title: Re: Pure external TSF tibia and walking
Post by: zaozari on February 02, 2022, 05:27:55 PM
Does any of you have used or know someone who used European (short, hand and arm support) or/and "American" (longer, armpit and hand support) crutches or have an idea which are more practical,  confortable or saffer?
Title: Re: Pure external TSF tibia and walking
Post by: Medium Drink Of Water on February 02, 2022, 07:47:01 PM
The short, hand/arm support crutches are appropriate for people with two bad legs.  Armpit crutches are for people with one bad leg.
Title: Re: Pure external TSF tibia and walking
Post by: ReadRothbard on February 02, 2022, 08:10:33 PM
That's funny--in America, we often call those "Canadian crutches".
Title: Re: Pure external TSF tibia and walking
Post by: zaozari on February 02, 2022, 09:04:01 PM
The short, hand/arm support crutches are appropriate for people with two bad legs.  Armpit crutches are for people with one bad leg.
So with both legs with externals you would advise short crutches or only if one of the legs is bringing extra problems?
Title: Re: Pure external TSF tibia and walking
Post by: Medium Drink Of Water on February 02, 2022, 10:55:30 PM
With frames on I would recommend a walker.
Title: Re: Pure external TSF tibia and walking
Post by: zaozari on February 02, 2022, 11:21:04 PM
With frames on I would recommend a walker.
Thanks. You did externals, no? You tolerated a walker for how many months?
Title: Re: Pure external TSF tibia and walking
Post by: hasaki on February 18, 2022, 10:03:04 PM
Even if I use the LONG method I can't fully deadlift or walk until my bones are fully consolidated? My family often asks me to leave the walker to practice walking and squatting, I think this may be the reason why my height shrunk after I stopped lengthening.
Title: Re: Pure external TSF tibia and walking
Post by: ReadRothbard on February 18, 2022, 10:05:49 PM
Even if I use the LONG method I can't fully deadlift or walk until my bones are fully consolidated? My family often asks me to leave the walker to practice walking and squatting, I think this may be the reason why my height shrunk after I stopped lengthening.

I think you can do bodyweight stuff and the such until you're fully consolidated.
Title: Re: Pure external TSF tibia and walking
Post by: hasaki on February 18, 2022, 10:56:28 PM

I don't know if it's because of the squat, but at the moment I'm gradually losing height, spending a lot of money and time and physical pain and not getting the height I should be, it's frustrating.
Title: Re: Pure external TSF tibia and walking
Post by: ReadRothbard on February 18, 2022, 11:45:57 PM
I don't know if it's because of the squat, but at the moment I'm gradually losing height, spending a lot of money and time and physical pain and not getting the height I should be, it's frustrating.

Wait, what? How are you losing height?
Title: Re: Pure external TSF tibia and walking
Post by: hasaki on February 18, 2022, 11:48:33 PM
No idea. From 173+ to 170
Title: Re: Pure external TSF tibia and walking
Post by: zaozari on February 23, 2022, 02:29:34 PM
In another topic somebody said loss of weight was due to muscle atrophy for being  too much time in bed or immobilised, but not sure, because in general, the less a man exercises, the fatter and heavier he gets. Maybe then muscle mass, being heavier, is lost quicker than fat is acquired??

But maybe that explanation was for example for Precice; doing externals allows some body bearing, efforts to move the crutches, the walker or even a wheelchair, as well as desirably, daily physiotherapy and bike from the beginning, so it would be natural to lose some weight from that "side".
This would be also choerent with some reports also here in the forum that people doing LL also lose appetite, at least during some time.

Title: Re: Pure external TSF tibia and walking
Post by: ReadRothbard on February 23, 2022, 08:43:15 PM
No idea. From 173+ to 170

That's really strange. What does your doctor say?
Title: Re: Pure external TSF tibia and walking
Post by: Righteous on February 24, 2022, 03:27:03 AM
Even if I use the LONG method I can't fully deadlift or walk until my bones are fully consolidated? My family often asks me to leave the walker to practice walking and squatting, I think this may be the reason why my height shrunk after I stopped lengthening.
Wait. I am skeptical that you were not doing adequate exercises or other things to have guanrateed your bones' complete consolidations were you? That you can not walk normally is pretty explanatory about the reason that you didn't achieve the height you want. Maybe your consolidations were not good and your height shrank spontaneously. But external fixators themselves will lead to shrinkages due to the nails bending.
Title: Re: Pure external TSF tibia and walking
Post by: zaozari on February 24, 2022, 12:18:19 PM
Wait. I am skeptical that you were not doing adequate exercises or other things to have guanrateed your bones' complete consolidations were you? That you can not walk normally is pretty explanatory about the reason that you didn't achieve the height you want. Maybe your consolidations were not good and your height shrank spontaneously. But external fixators themselves will lead to shrinkages due to the nails bending.

First, in pure externals there are no nails.

Second, in the hands of a good experienced surgeon wires and pins of good quality that are correctly positioned, thus where tension is properly set up, they very rarely bend. When this happens that's due to weakness of periosteum or undue movement or impacts that are not tolerated and only happen by accident if for example crutches or a walker are not properly used or a strong impact happens.

Thirdly, if any bending occurs, there's threat of misalignment, not shrinkages, except very milimetrically in the more recently part of the callus, and if really proper tension and counter tension was not created when positioning the wires.

Lastly, one of the advantages of Ilizarov or Taylor frames is that any misalignments may start to be immediatly corrected, provided the process is being properly monitored by the doctor with frequent Rx and observation.
Title: Re: Pure external TSF tibia and walking
Post by: Righteous on February 24, 2022, 01:23:42 PM
First, in pure externals there are no nails.

Second, in the hands of a good experienced surgeon wires and pins of good quality that are correctly positioned, thus where tension is properly set up, they very rarely bend. When this happens that's due to weakness of periosteum or undue movement or impacts that are not tolerated and only happen by accident if for example crutches or a walker are not properly used or a strong impact happens.

Thirdly, if any bending occurs, there's threat of misalignment, not shrinkages, except very milimetrically in the more recently part of the callus, and if really proper tension and counter tension was not created when positioning the wires.

Lastly, one of the advantages of Ilizarov or Taylor frames is that any misalignments may start to be immediatly corrected, provided the process is being properly monitored by the doctor with frequent Rx and observation.
Sorry English is not my primary language. I meant 'pins' by 'nails'.
Title: Re: Pure external TSF tibia and walking
Post by: hasaki on February 24, 2022, 05:51:58 PM
I think I found the reason, after removing the external fixation my bones had misalignments and the two broken bones were not aligned. My thighs are turned in and my calves are turned out.
Title: Re: Pure external TSF tibia and walking
Post by: zaozari on February 24, 2022, 08:50:56 PM
How come that you have misalignment in tights? Didn't you have frames in calves only?

It seems you had a really bad surgeon, you need support from an experienced prestigious one to treat and correct that so bad situation.
Correct wiring is what makes the best or worst outcomes. And it's clear in many Pubmed articles that surgeon's experience and responsibility is crucial  for good outcomes, the more important factor, above anything else.
Title: Re: Pure external TSF tibia and walking
Post by: Righteous on February 25, 2022, 02:00:20 AM
How come that you have misalignment in tights? Didn't you have frames in calves only?

It seems you had a really bad surgeon, you need support from an experienced prestigious one to treat and correct that so bad situation.
Correct wiring is what makes the best or worst outcomes. And it's clear in many Pubmed articles that surgeon's experience and responsibility is crucial  for good outcomes, the more important factor, above anything else.
I think he means 'baker leg' by the statements of that paragraph. He did't say 'he had bone misalignment in his thighs' instead he only mentioned he had misalignment
Title: Re: Pure external TSF tibia and walking
Post by: hasaki on February 25, 2022, 04:43:08 AM
No, LL surgery for femur.
Title: Re: Pure external TSF tibia and walking
Post by: zaozari on February 26, 2022, 02:35:59 PM
I think I found the reason, after removing the external fixation my bones had misalignments and the two broken bones were not aligned. My thighs are turned in and my calves are turned out.

I don't understand anymore your exact situation (tibias, femurs, externals in one, both? The topic was about tibias....). But if you had misalignments why had you the external fixators removed instead of using them to solve the problem? If they were Ilizarov or TSF it wouldn't have been very complex to correct the misalignments. In fact that's what you may need now. Or maybe I'm missing something here.
Very slight "shrinkage" may be due to a too "fragile" synthesis of the callus, not retracting when needed, for example, but the surgeon should have done a better follow-up and would have seen it in Rx and advised you to more support and less own (alone) weight bearing.

Also, you say you lost around 3 pounds? That's around 1,5 kg, no? What's the issue there? I often change around 500/600 g one day to the other, up or down. On a little degree, but weight depends on doing light or heavy exercise that day, food, poo, water intake, hour of measurement, calibration of scales, etc
Title: Re: Pure external TSF tibia and walking
Post by: hasaki on February 27, 2022, 02:14:03 AM
First of all my surgery was on the femur, secondly livelife removes external fixators the first day after the patient stops lengthening, also I feel whether it is their staff being lazy and not informing the doctor of any of my conditions, whether I react to pain, numbness in my leg (which was diagnosed after I saw another doctor and I currently have no control over my toe), or infection, they always say it is normal.
Title: Re: Pure external TSF tibia and walking
Post by: hasaki on February 27, 2022, 02:16:04 AM
In addition I still have severe pain three months after removal of the external fixator
Title: Re: Pure external TSF tibia and walking
Post by: zaozari on February 27, 2022, 09:21:46 AM
I am sorry for all that. And had no idea that externals in femurs were removed immediately after lenghtening.
I hope you find the right staff to make you get totally fit, it seems a complicated situation but not untreatable at all.
Best wishes.