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[yash]

hello guys, had the surgery yesterday.. couldnt write much yesterday due to sleepiness..
after over an year of consideration have decided to undergo cross lengthening. my current height is 1.64m target is to reach 1.74m.
so yesterday had my left femur done with lrs fixator and right tibia done with ilizarov ring fixator.. with an intramedullary nail
the surgery took a lot of time, nearly six hours, apparently my bones  were harder than usual to do a perfect corticomy...
i am attaching the pics of fixators... post operative xrays will be taken tomorrow..

https://imgur.com/a/UQPKeQl

[Thehighest]

oh my bad six hours, is the same time as if you have done a bilaterial tibia LON?

[yash]

oh my bad six hours, is the same time as if you have done a bilaterial tibia LON?

of the six hours, femur took 4 hours and tibia took 2 hours. and even according to dr saini bilateral tibia would take only 4 hours, since its easier to access.

[DonBones]

hello guys, had the surgery yesterday.. couldnt write much yesterday due to sleepiness..
after over an year of consideration have decided to undergo cross lengthening. my current height is 1.64m target is to reach 1.74m.
so yesterday had my left femur done with lrs fixator and right tibia done with ilizarov ring fixator.. with an intramedullary nail
the surgery took a lot of time, nearly six hours, apparently my bones  were harder than usual to do a perfect corticomy...
i am attaching the pics of fixators... post operative xrays will be taken tomorrow..

https://imgur.com/a/UQPKeQl

That's a long surgery. Perhaps with harder bones they will also heal faster

Cross lengthening sounds like one of the higher difficulty levels, hope you will be alright and good luck

[yash]

yeah bro, thats the reason, i have very safe limits in each bone... chose cross because physio becomes lot easier.. when the frames are not adjacent to each other- tibia.. and i will not have enough mobility if i go for bilateral femur...

[DonBones]

yeah bro, thats the reason, i have very safe limits in each bone... chose cross because physio becomes lot easier.. when the frames are not adjacent to each other- tibia.. and i will not have enough mobility if i go for bilateral femur...

How long will all of this take?

[yash]

How long will all of this take?

Surgery yesterday
Start of distraction- 6th day
Distraction- 50 days
15 day gap to restore Rom
2nd surgery
Same as above..
Best case scenario- will remove all 4 fixators by my bday in 1st week of jan
Return to normal walking after 2 months .

[yash]

Pain was the worst on the night after surgery... Never experienced such pain so Will give it a 10/10..only the epidural helped then..now pain is fading away real fast..and movement is increasing rapidly... according to Dr hirdesh..it is common for swelling to occur upto  2 weeks..

[yash]

The entire team deserves a special mention, since they are really concerned about me..I also am constantly under supervision of one of their staff during the entire hospital stay..will probably shift to guest house after 5 days in hospital.2 days to go

[yash]

My reasons for undergoing ll:
Being less than 10 percentile in height has always affected my confidence ever since I was in high school .I tried a lot of remedies to grow taller, but none of them actually work.these include homeopathy & Ayurveda meds, stretching exercises etc..even during my undergraduate years, I always felt people gave less respect to short guys...no matter what kind of person a tall guy is, they used to be the talk of the town. So undergoing this procedure was really important for me to regain my confidence..I am lucky to have supportive parents who agreed with my decision.. and found a dedicated ll team.

[DonBones]

Good luck!

[yash]

Good luck!

thank you 

[yash]

post operative xrays: .
https://imgur.com/a/tv8de0K

[yash]

as people say, femurs are definitely more difficult to handle than tibias, doing one femur at a time is being hard for me due to restricted movement of the thigh...must be really difficult for people who chose bilateral femurs..doing everything to improve my ROM and reduce swelling.

[yash]

I actually regretted doing femur since morning..but just had my first physiotherapy session and am very happy to say that proper physiotherapy plays a big role in femur patients to reduce suffering.we did physiotherapy for about 30 minutes and pain levels dropped by atleast 50-60% and my knee flexion which previously was no more than 30° improved significantly to atleast 80%.an experienced physiotherapy team is really important for this surgery from start to end..also as seen in my x-rays saini sir did a great job in not inserting the half pins theough the knee..seen some surgeons doing that and those patients having significant knee issues .

[Growing]

Thanks for the update man. I wishing you a speedy recovery. Respect for going all in.

[yash]

Thanks for the update man. I wishing you a speedy recovery. Respect for going all in.

yep growing, i just wanted this to be a one time affair for life. going for single segment would safely take me to a max of 169-170, which is still below 30 percentile . so had to go for both segments.  also once all the nails are locked there isnt much difference between externals and interrnals

[Sorcerer]

yep growing, i just wanted this to be a one time affair for life. going for single segment would safely take me to a max of 169-170, which is still below 30 percentile . so had to go for both segments.  also once all the nails are locked there isnt much difference between externals and interrnals

There are crucial differences between internal and external femurs.The latter advangtages the former very much in any aspect except price.

[yash]

There are crucial differences between internal and external femurs.The latter advangtages the former very much in any aspect except price.

I was talking about advantages post locking of nails..except scars, what others do you have in mind?

[Thehighest]

Did your doctor mention the risk of nail breakage?

[yash]

Did your doctor mention the risk of nail breakage?

During lengthening or consolidation?

[Thehighest]

During consolidation

[yash]

During consolidation

Nail breaking during consolidation is a risk that is very rare and usually due to small diameter of nail and excessive activity before proper consolidation..it is a very easily preventable complication by adhereing to safe limits..by the way the complication is the same for externals and internals..

[yash]

Day 11 post surgery..
Lengthened 5mm so far in both tibia and fenur..will have my first xray in a week, after which Dr hirdesh will decide whether to go 1.25mm in the femur...though there is no pain femur is really discomfortable..want to get rid of the frame as soon as possible..on the other hand, I am not really worried about tibia frame at all..it hardly causes any discomfort.

[yash]

We are working really hard to restore ROM, but complete ROM is expected after fixator removal since the schanz pins may obstruct movement of muscles and tendons in the femur

[notadetective]

Day 11 post surgery..
Lengthened 5mm so far in both tibia and fenur..will have my first xray in a week, after which Dr hirdesh will decide whether to go 1.25mm in the femur...though there is no pain femur is really discomfortable..want to get rid of the frame as soon as possible..on the other hand, I am not really worried about tibia frame at all..it hardly causes any discomfort.

Hi yash,

Cross lengthening is very hard and I wish you good success in this journey. With the support of the team I am sure you will reach your goals and recover with determination.

Is the PT deciding the lengthening rate for you? I think you should check with your surgeon.

Do you know of any success stories with cross lengthening at your center? What is the average length they are able to get for their patients through cross lengthening?

Cross lengthening is usually done when wearing ex-fix on femur right? Is there really a benefit of doing it with monorial on femur? Do you find it convenient compared to bilateral tibia which other patients must be doing there?

Good luck yash, I will follow this diary

[yash]

Hi yash,

Cross lengthening is very hard and I wish you good success in this journey. With the support of the team I am sure you will reach your goals and recover with determination.

Is the PT deciding the lengthening rate for you? I think you should check with your surgeon.

Do you know of any success stories with cross lengthening at your center? What is the average length they are able to get for their patients through cross lengthening?

Cross lengthening is usually done when wearing ex-fix on femur right? Is there really a benefit of doing it with monorial on femur? Do you find it convenient compared to bilateral tibia which other patients must be doing there?

Good luck yash, I will follow this diary

Hey notadetective,

Thank you for your kind words..I know cross is difficult and that's the reason I have very realistic goals in each segment.there are not many things that can go wrong in 4.5cm lengthening per segment.

Though I would confirm it with surgeon, i would still trust Dr Hirdesh as he has over 12 years of experience with ll patients.in fact I was really surprised by his knowledge even of the surgical processes and different kinds of ll devices which even some surgeons don't have.

There have been 4 other cross lengthenings here, one of whom I personally contacted with...they did in the range of 11- 14 cm

I am doing with monorail on femur . ilizarov femur is so barbaric in my opinion.i mean we can't even take a poop with it. monorails is the standard here for any femur lengthenings.i can't compare it with bilateral tibia because, if u want one segment u will go with tibia..if you want both cross is the only way. Don't even think of bilateral femurs since discomfort will be unthinkable..in my case with one femur it's a bit uncomfortable but manageable..I am just counting days when the femur frame will be removed

[yash]

Knee Rom has improved significantly. currently it is above 100° flexion and normal extension. But complete ROM is expected after frame removal since pins may obstruct smooth movement of muscles and tendons.
Attached is knee ROM pic..no issues with tibia leg, can flex as much as the frame allows
http://imgur.com/a/UXtPWEh

[yash]

1cm taller so far. things are improving pretty fast. the only issues i am facing are the discomfort with the frames and mild knee and calf pain in the femur leg. this pain may be due to distraction. taking mobizox(skeletal muscle relaxant+diclofenac) and tramadol( opiod analgesic) alternatively to deal with this  pain, patience is the key for femur lengthenings. things will improve from 12-14th day. attaching a video of the physiotherapy session.

https://imgur.com/a/afIUjad

[GrowANut]

You seem to have really good mobility for just undergoing the surgery good job man keep it up.

[yash]

You seem to have really good mobility for just undergoing the surgery good job man keep it up.

thanks mate, i think the regular physiotherapy is paying off