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Author Topic: Is gastrocsoleus recession needed for tibia lengthening?  (Read 243 times)

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chasingthedream

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Is gastrocsoleus recession needed for tibia lengthening?
« on: September 08, 2020, 05:54:13 PM »

Hey there!

 

In this video starting from minute 16:00, Dr. Robert Rozbruch states that for most of those who want to lengthen their tibia for more than 4 cm, gasterosoleus resession is a must. Now this scares me a little bit. Is it even true? We know that a reasonable limit for tibial lengthening is 5-6 cm. Does that mean everyone should do this surgery? did anyone who did tibia lengthening undergo this surgery?
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ghkid2019

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Re: Is gastrocsoleus recession needed for tibia lengthening?
« Reply #1 on: September 08, 2020, 06:09:15 PM »

U will get ballerina foot if u don't do it. Alternative is calf board dorsiflex stretch like crazy, many hours a day. With weight bearing nails standing also helps a little

I am not an eggspert so I am just putting what I know. I don't think it's mandatory, there's definitely some diaries I read without this procedure. But u gotta stretch alot the dorsiflexion exercise
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chasingthedream

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Re: Is gastrocsoleus recession needed for tibia lengthening?
« Reply #2 on: September 08, 2020, 06:19:01 PM »

I'm planning to do 5 cm in the tibia and I'm scared like hell because of that and I can't take any other procedures. Do you think if I follow a very good physiotherapy program during the lengthening, will it be enough to a point where I can walk without pain?
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ghkid2019

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Re: Is gastrocsoleus recession needed for tibia lengthening?
« Reply #3 on: September 08, 2020, 06:38:13 PM »

Definitely, 5/6cm is about the limit and pushing it for without the gastro recess. Plenty have done 5cm without gastro recess and are fine. You definitely want to avoid gastro recess at all costs. I would not go to 6cm, tho plenty of people do 6cm in Korea Tibias without gastro recess. That's why Rozbruch put 4cm as limit. 5cm is really the limit for a normal person, 4cm is a safe limit. 6 is pushing it

Stretch alot yeah u gotta dedicate urself. I will prob slack off lol something like 90% of people slack off in this surgerys rehab and stretching so I prob won't be different. Paley said everyone be like "omg imma be the most work ethic work ethic god and work ethic jesus" but like everyone slacks off a week in besides like very few people

I mean tho tibia lengthening is hard, ur probably still gonna have pain when u walk, but you'd be able to avoid ballerina
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chasingthedream

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Re: Is gastrocsoleus recession needed for tibia lengthening?
« Reply #4 on: September 08, 2020, 06:58:57 PM »

thanks for the replies, ghkid2019.

speaking of pain, What part of the leg exactly hurts while walking? is it joints/knee, muscles/tendons, or a general feeling? Will it still hurt say 1 year post surgery? Can I still have the freedom of movement as before or Am I going to experience some limitations in terms of walking and jogging?

btw, can you pls mention those diaries in which people lengthened 5-6 cm and didn't have ballerina foot problems? ty
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wannabeidol

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Re: Is gastrocsoleus recession needed for tibia lengthening?
« Reply #5 on: September 08, 2020, 07:03:12 PM »

thanks for the replies, ghkid2019.

speaking of pain, What part of the leg exactly hurts while walking? is it joints/knee, muscles/tendons, or a general feeling? Will it still hurt say 1 year post surgery? Can I still have the freedom of movement as before or Am I going to experience some limitations in terms of walking and jogging?

btw, can you pls mention those diaries in which people lengthened 5-6 cm and didn't have ballerina foot problems? ty

youll have all sorts of pain:
pain in the bone from the break
tightness in the muscles
weakness in the muscles
tightness in the tenons
shooting elctrical pain from nerves stretching
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chasingthedream

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Re: Is gastrocsoleus recession needed for tibia lengthening?
« Reply #6 on: September 08, 2020, 07:12:42 PM »

Correct  :-[ but Does the pain reduces over time?

I feel like most of the problems associated with muscles and tendons can be resolved by following the physiotherapy program diligently. Also, why would the bone hurt from where it breaks after it completely heals? I think that with time most the pain vanishes. correct me if i'm wrong.ty
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wannabeidol

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Re: Is gastrocsoleus recession needed for tibia lengthening?
« Reply #7 on: September 08, 2020, 07:13:58 PM »

Correct  :-[ but Does the pain reduces over time?

I feel like most of the problems associated with muscles and tendons can be resolved by following the physiotherapy program diligently. Also, why would the bone hurt from where it breaks after it completely heals? I think that with time most the pain vanishes. correct me if i'm wrong.ty

from what ive read
postop is most of the swelling pain from the break
and the more you lengthen, the worse the tightness gets
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wannabeidol

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Re: Is gastrocsoleus recession needed for tibia lengthening?
« Reply #8 on: September 08, 2020, 07:17:12 PM »

nerve pain is usually an indicator of lengthening too fast however some people get it regardless.
usually the first 3 cm is relatively easy, but the more you lengthen the harder it gets, and the more painful.
4-5 will be challenging 5+you might quit
 the worst is the pain will come and go and you cant really predict it.
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wannabeidol

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Re: Is gastrocsoleus recession needed for tibia lengthening?
« Reply #9 on: September 08, 2020, 07:21:58 PM »

sorry yes the break pain will eventually go away, however it will be replaced with differnt types of pain. the physiotherapy seems to be less about keeping your range of motion and more slowing down your rapidly deteriorating ROM.
this is because bone grows faster than soft tissue. the moment you stop distracting, your pain will drastically improve. and your body will make more muscle/tendon/nerves to accomodate your new length
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HD

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Re: Is gastrocsoleus recession needed for tibia lengthening?
« Reply #10 on: September 08, 2020, 09:23:55 PM »

I noticed more pain in femur lengthening( Stryde) than in tibia lengthening( external).
For example if we check Pili dairies there is no painkillers after some weeks, while  stryde diaries keep take painkillers for all the procedure.
Moreover at the end of procedure external fixator patients have like 0 pain while I noticed on stryde, that before nail removal, there is a disconfort sensation.
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wannabeidol

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Re: Is gastrocsoleus recession needed for tibia lengthening?
« Reply #11 on: September 08, 2020, 10:18:52 PM »

I noticed more pain in femur lengthening( Stryde) than in tibia lengthening( external).
For example if we check Pili dairies there is no painkillers after some weeks, while  stryde diaries keep take painkillers for all the procedure.
Moreover at the end of procedure external fixator patients have like 0 pain while I noticed on stryde, that before nail removal, there is a disconfort sensation.

ive noticed diaries mention that tibia paitents typically get lesspain/better sleep. maybe its due to more trauma to soft tissue? i guess the trade off is you can get more length out of the nail before you get tightness issues?
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a

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Re: Is gastrocsoleus recession needed for tibia lengthening?
« Reply #12 on: September 08, 2020, 10:41:39 PM »

Can someone explain what is this topic about? I'm sorry my english isn't good enough to understand articles about biology etc. I mean I can but it'll take too much time translating all kinds of scienctific words.
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wannabeidol

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Re: Is gastrocsoleus recession needed for tibia lengthening?
« Reply #13 on: September 08, 2020, 10:49:17 PM »

Can someone explain what is this topic about? I'm sorry my english isn't good enough to understand articles about biology etc. I mean I can but it'll take too much time translating all kinds of scienctific words.
so as you know the limiting factor to limb lengthening is soft tissue.
when  you lengthen the femur usually your tensor fascia lata will prevent you from lengthening( paley always cuts this tendon for his patients)
when you lengthen the tibia, the gascroc tendon is cut in order to prevent development of contractures
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Re: Is gastrocsoleus recession needed for tibia lengthening?
« Reply #14 on: September 08, 2020, 10:56:39 PM »

Thank you. That was plain and simple.
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Medium Drink Of Water

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Re: Is gastrocsoleus recession needed for tibia lengthening?
« Reply #15 on: September 09, 2020, 12:03:16 AM »

I did not get the surgery done and I lengthened 7.5 cm on tibias.  In fact, most people in Beijing at the time did not get it done either and they were all doing about the same amount.  Dr. Xia used a spring-loaded half-ring on the heel to prevent ballerina foot, and I think it helped me, but some people disliked it and had it removed from the fixators.  Their results seemed about the same.

I left the hospital in a wheelchair, barely even able to use a walker, but over the course of several months I did gradually regain the ability to walk.  I think this surgery might be more about time than anything else, for the purpose of a speedy recovery, though I suppose some people who are naturally tight would need it no matter what.

speaking of pain, What part of the leg exactly hurts while walking? is it joints/knee, muscles/tendons, or a general feeling? Will it still hurt say 1 year post surgery? Can I still have the freedom of movement as before or Am I going to experience some limitations in terms of walking and jogging

It's the feet and ankles that are the killer while walking.  Sharp, stabbing pains.  The rest is a dull ache, but that is more than just while walking.

It will not hurt one year post surgery and you won't have limitations walking or jogging.  Running is mostly OK too.
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Gained 3 inches on tibias (Ilizarov LON) in 2007 at the Beijing Institute of External Skeletal Fixation Technology with Prof. Hetao Xia and Dr. Aiming Peng.

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