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Author Topic: Unilateral tibias external fixator 2023  (Read 317 times)

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limby101

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Unilateral tibias external fixator 2023
« on: July 24, 2023, 05:07:30 PM »

I wasn't planning to share this but I'm bored in the hospital so I figured...

I'm 31 from Europe.
Starting height 168.
Was planning to do 5-6 but decided on 3+ during the process.

I also have varus deformity so the hexapod was supposed to also fix it.

The plan was to do both legs but with 2 weeks time gap, which honestly I can't see how it is a wiser way to go.
I do realize the experience is a lot harder than expected, perhaps its a bad surgeon technique or experience. I don't know.

During the lengthening I had 2 infected pin sites. They didn't respond to antibiotic treatment so they were removed.
Today I'm 2 months after surgery, at 3+ cm and varus about 80 percent corrected.
But still dealing with infections and more pins are about to be removed.
This infection issue should be taken very seriously as it adds much difficulties to the process, it's painful, requires more surgeries, prolonging healing and chronic osteomyelitis is something that can put your future body function in serious compromise.

At the moment I have some issues I don't understand.
1- the surgeon keeps suggesting removing the frame and putting an internal nail instead (, basically LATN). this is what I intended myself prior to surgery, but with time I learned the sad truth - every intervention has risk poential, why take the risk? And more importantly, an infection of pin sites is a contraindication for putting a nail, as it would greatly increase risk for the nail to get infected and that's serious trouble.
However, the doc suggests a nail that is covered with antibiotic. This makes me consider it more, but I'm still very afraid of more complications.

2- the time to consolidate. I'm already 2.5 months after surgery, lengthening stopped about 3 weeks ago. I don't know why but the doc predicts about 5-6 months of consolidation, that is starting from now. That makes it 7-8 months overall with the fixator on, for 3 cm(!!!). I can't find sense in this prediction and it honestly puts me down so much and the depression is real.

So I don't know exactly what to expect.
Don't have much hope of surviving this ok.

Bottom line, for today, I wouldn't recommend doing this surgery, unless youre under 165 or something like that.
At least not external fixator method.

Good luck to all.
Will try to update
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TheDream

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Re: Unilateral tibias external fixator 2023
« Reply #1 on: July 24, 2023, 10:44:18 PM »

Strange about the pin site infections and the issues with anti biotics, but still very valuable information so thank you for sharing.

May I ask which country you are being treated in? I’m asking due to other people saying their pin site infections went away immediately after anti biotics, and I’ve never ever heard of a doctor suggesting covering a nail or rod with anti biotics before that sounds a bit weird, but I’m no doc so take this with a grain of salt.

Maybe others can provide more insight
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Maison

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Re: Unilateral tibias external fixator 2023
« Reply #2 on: July 25, 2023, 03:01:26 AM »

1- the surgeon keeps suggesting removing the frame and putting an internal nail instead (, basically LATN). this is what I intended myself prior to surgery, but with time I learned the sad truth - every intervention has risk poential, why take the risk? And more importantly, an infection of pin sites is a contraindication for putting a nail, as it would greatly increase risk for the nail to get infected and that's serious trouble.
However, the doc suggests a nail that is covered with antibiotic. This makes me consider it more, but I'm still very afraid of more complications.

Your doctor might be considering the use of an intramedullary nail, as referenced here:
http://synthes.vo.llnwd.net/o16/LLNWMB8/INT%20Mobile/Synthes%20International/Product%20Support%20Material/legacy_Synthes_PDF/096579.pdf

I wonder why you've developed severe pinsite infection, especially when you're under the care of a doctor who has access to such an advanced intramedullary nail.


Based on the paper at https://journals.sagepub.com/doi/10.1177/10225536221118521, it seems that the therapeutic outcomes of antibiotic-coated intramedullary nails are favorable.
Therefore, if your pin site infection is difficult to control and the surgeon recommends LATN, it would be reasonable to undergo the surgery after receiving a thorough explanation from the doctor.
« Last Edit: July 25, 2023, 04:12:04 AM by Maison »
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