Limb Lengthening Forum

Limb Lengthening Surgery => Limb Lengthening Discussions => Topic started by: shortbutstunning on September 02, 2022, 07:25:11 PM

Title: LON Tibia little bone healing 6 months later, please help
Post by: shortbutstunning on September 02, 2022, 07:25:11 PM
I did LON on tibia and removed the external fixator 6 months ago.  6 months later I have little bone growth especially on my right leg.  I think it's a mixture of things, diet/sleep/exercise was really bad and I was using crutches for longer on the right side as well as not putting much pressure on it due to pain/nerve damage.

What are my options?  Anybody been through this and at what stage should slow bone healing be a concern? 

My doctor suggested nail replacement surgery, but I don't have the money/time etc.  and I could risk losing my job if I take more time off this year.  I also mentally don't want to go through surgery again unless I absolutely have to.  If it's just slower healing I can do it, I started taking supplements, eating right and exercising after this x-ray to see if that improves my condition.

I would really appreciate some advice here.


(https://cdn.dapp.com/attachments/1000565110563156039/1015340288975327283/EFD4ED96-4088-4184-AF5C-BB6205B08963.jpg)

(side view looks slightly better for right leg, but I don't have photos)
Title: Re: LON Tibia little bone healing 6 months later, please help
Post by: Medium Drink Of Water on September 02, 2022, 07:49:05 PM
How would replacing the nail help?
Title: Re: LON Tibia little bone healing 6 months later, please help
Post by: shortbutstunning on September 02, 2022, 07:51:52 PM
How would replacing the nail help?

this is why i was confused, because i haven't really read about replacing nails happening a lot especially 6 months in and wanted some input if it's really necessary to go through surgery like this again.

Does exchanging the nail simulate bone growth?  I haven't read any articles like this, but this is what the doctor claimed
Title: Re: LON Tibia little bone healing 6 months later, please help
Post by: we.live.once on September 02, 2022, 08:29:30 PM
this is why i was confused, because i haven't really read about replacing nails happening a lot especially 6 months in and wanted some input if it's really necessary to go through surgery like this again.

Does exchanging the nail simulate bone growth?  I haven't read any articles like this, but this is what the doctor claimed
how many cm did you lengthened? I am thinking can it be because you were lengthening too fast?
Title: Re: LON Tibia little bone healing 6 months later, please help
Post by: Medium Drink Of Water on September 02, 2022, 09:49:28 PM
It's OK to leave the nails in forever.  So I think the worst-case scenario isn't too bad.

If you haven't been standing or walking much, doing that will help.  Stand a lot and walk a lot.  Carry heavy weights while you stand and walk.  Also make sure you're eating plenty of all the proper nutrients and avoiding bad stuff like smoking and drinking.  Make sure you're sleeping enough.  Get prescription sleeping pills if that's what it takes.  I slept for 12 hours a night for the first 6 months after lengthening.
Title: Re: LON Tibia little bone healing 6 months later, please help
Post by: boklecrt on September 03, 2022, 02:04:09 AM
I did LON on tibia and removed the external fixator 6 months ago.  6 months later I have little bone growth especially on my right leg.  I think it's a mixture of things, diet/sleep/exercise was really bad and I was using crutches for longer on the right side as well as not putting much pressure on it due to pain/nerve damage.

What are my options?  Anybody been through this and at what stage should slow bone healing be a concern? 

My doctor suggested nail replacement surgery, but I don't have the money/time etc.  and I could risk losing my job if I take more time off this year.  I also mentally don't want to go through surgery again unless I absolutely have to.  If it's just slower healing I can do it, I started taking supplements, eating right and exercising after this x-ray to see if that improves my condition.

I would really appreciate some advice here.


(https://cdn.dapp.com/attachments/1000565110563156039/1015340288975327283/EFD4ED96-4088-4184-AF5C-BB6205B08963.jpg)

(side view looks slightly better for right leg, but I don't have photos)


left side looks fine, very slow healing but there is clear union. here are some examples of xrays at 4-5 months:

 (https://s8d8.turboimg.net/t1/79683628_IMG_2501.png) (https://www.turboimagehost.com/p/79683628/IMG_2501.png.html) (https://s8d8.turboimg.net/t1/79683629_IMG_2503.png) (https://www.turboimagehost.com/p/79683629/IMG_2503.png.html)

as its obvious, it naturally heals disproportionately on one side


however your right tibia looks like non union

post your frame removal xrays to judge progress for 6 months.
we need front+sides and include your fibula as well to see whats going on there too


It's OK to leave the nails in forever.  So I think the worst-case scenario isn't too bad.

If you haven't been standing or walking much, doing that will help.  Stand a lot and walk a lot.  Carry heavy weights while you stand and walk.  Also make sure you're eating plenty of all the proper nutrients and avoiding bad stuff like smoking and drinking.  Make sure you're sleeping enough.  Get prescription sleeping pills if that's what it takes.  I slept for 12 hours a night for the first 6 months after lengthening.

sound advice if his right tibia looked like the left, but he most likely has non union on the right tibia

also can you use caution when advising people to carry heavy weights? you didnt clarify to him at all about this statement. for all we know he could take your advice at face value and go pick up 2 25kg dumbbells at the gym, take a step and have the entire weight of the body+the dumbbells on only one leg and break his screws and collapse his regenerate


at least clarify you mean a two legged leg press within the weight limits of the nails like you used to do
Title: Re: LON Tibia little bone healing 6 months later, please help
Post by: Ascender on September 05, 2022, 07:05:27 PM
Did your surgeon try a bone growth stimulator machine?

Also, aside from sleep/diet/exercise, where they any other factors that could have cause this? Such as medication, health conditions, use of NSAID, etc.
Title: Re: LON Tibia little bone healing 6 months later, please help
Post by: shortbutstunning on September 11, 2022, 09:00:45 PM
thanks guys,

my surgeon did not try a bone growth stimulator machine, i am back in my homecountry(uk) and here they have no experience with this kind of surgery so i am not getting any help

i will try to get more xrays

what kind of weight exercises can i do to improve bone healing? 
Title: Re: LON Tibia little bone healing 6 months later, please help
Post by: Ascender on September 12, 2022, 06:04:09 PM
Any weight bearing (be careful though) will help. Also take Vitamin D3, Vitamin K2 Mk7, and calcium. Get a lot of sunlight. Dont use any NSAID painkillers.

Who was the surgeon that did this to you? Does he have anything to say about this? You can DM me if you don't want it to be public.

Title: Re: LON Tibia little bone healing 6 months later, please help
Post by: motoboarder on September 12, 2022, 06:31:43 PM
How much did you lengthen? This looks like a 4cm? Also how many mm did you lengthen per day?

From your post I think you had most issues with nutrients, sleep and general rest. You should not be stressed. Fear of loosing your job is a concerning stress. Do something about it. Your body is more precious than any jobs you do in your life. Finding a next job is better than fixing a LL complication. Do you have family members to help you?

Be careful with weight bearing exercises for bone healing. During my consolidation, I was fully on wheelchair + walker. I started crutches when the doctor gave me green light for unaided walking.

Relax, eat, sleep, rest like a king! We have just 1 shot at doing LL in our whole life. Don't bother with other stresses.
Title: Re: LON Tibia little bone healing 6 months later, please help
Post by: NotTall84 on September 13, 2022, 09:08:00 AM
are you getting in adequate protein and minerals?

Try a bone building supplement with MCHA calcium and magnesium + vitamin K2.