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Author Topic: Small LLD correction with Dr. Rozbruch  (Read 548 times)

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Hamza

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Small LLD correction with Dr. Rozbruch
« on: August 12, 2018, 07:31:21 AM »

Hi Guys

I am 34 years old, male, 82 kg, athletic.

My Right leg is shorter than my left leg by 10 mm resulting in imbalance and back pain. this 10 mm is distributed in femur, tibia and ankle after a surgery done since 10 years ago. Since that time i am sending my shoes to an orthopedic shoe lift center to modify all my shoes by cutting the sole and inserting a full lift of the amount needed to be able to walk and doing sports with good balance and without limping and back pain. I decided to get rid of this solution as the lift is noticeable and the shoes becomes very inflexible and not all shoes can be modified.

Because 10 mm is a small discrepancy yet affecting my life, I visited many of the top notch doctors in this field and i decided to correct this discrepancy via surgery with Dr. Rozbruch in HSS.

My surgery is in 2 weeks and i ll be treated with "femur lengthening precise nail 2" and hopefully with STRYDE if it will available before the surgery date.

I need the help of precise nail 2 patients (femur lengthening):

1- the surgery itself is painful ?
2- stiffness, nerves issue, or any other complications for 10 mm lengthening ?
3- back to normal life and sports after full recovery ?

I will also share my experience with u because i know many people has a small discrepancy and they suffer a lot from it and need a permanent solution other than inserting insoles and modifying soles.


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MirinHeight

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Re: Small LLD correction with Dr. Rozbruch
« Reply #1 on: August 12, 2018, 11:23:31 AM »

i have around a 10 mm difference too. (my right leg is shorter)
was this procedure covered by insurance?

also you should have no problem returning back to normal and you should have no nerve issues, stiffness, etc for only a 1 cm lengthening
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currently 179 cm with a 6'2 wingspan
Goal: 182.5-184 cm
top 5 LL surgeons: Paley, Rozbruch, Mahboubian, Parihar, Birkholtz

myloginacc

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Re: Small LLD correction with Dr. Rozbruch
« Reply #2 on: August 12, 2018, 11:43:27 AM »

Thank you, Hamza, for deciding to share your experience. There are many others in your situation who'll benefit from it.

I wish you the best of luck with everything concerning your limb length discrepancy's correction.
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Formerly myloginacct; had issues with my login account.
Yes I do want to add, before doing this surgery, ask yourself if you have optimized your life to the fullest extent possible (job/career, personality, etc).

tlannister

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Re: Small LLD correction with Dr. Rozbruch
« Reply #3 on: August 12, 2018, 12:51:08 PM »

Hopefully this forum will get its first Stryde diary.
Good luck
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Hamza

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Re: Small LLD correction with Dr. Rozbruch
« Reply #4 on: August 12, 2018, 02:03:51 PM »

MirinHeight,

yes it is covered but not 100%, they covered around 80% in my case.

do u use full lift insole, external shoe modification or u r fine without any correction ? I always use full lift because just adding a heel lift does not give me the balance i want.
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myloginacc

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Re: Small LLD correction with Dr. Rozbruch
« Reply #5 on: August 12, 2018, 03:37:39 PM »

Hamza, can I ask when you did first get the discrepancy precisely measured?

I'm assuming that was necessary for insurance to cover it.
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Formerly myloginacct; had issues with my login account.
Yes I do want to add, before doing this surgery, ask yourself if you have optimized your life to the fullest extent possible (job/career, personality, etc).

Hamza

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Re: Small LLD correction with Dr. Rozbruch
« Reply #6 on: August 12, 2018, 04:38:48 PM »

Hamza, can I ask when you did first get the discrepancy precisely measured?

I'm assuming that was necessary for insurance to cover it.

Since approximately 10 years ago and before doing my cavus foot surgery (high arch foot) in both legs.
They knew that i had 6 mm difference (5 in femur, 1 mm in tibia) and after the surgery i gained 4 more mm's in ankle so i end up having 10 mm difference and i started having noticeable imbalance and back pain when doing sports like football and squat in gym.

Do u have any discrepancy ? or aiming for texture lengthening ?
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myloginacc

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Re: Small LLD correction with Dr. Rozbruch
« Reply #7 on: August 12, 2018, 06:30:49 PM »

Since approximately 10 years ago and before doing my cavus foot surgery (high arch foot) in both legs.
They knew that i had 6 mm difference (5 in femur, 1 mm in tibia) and after the surgery i gained 4 more mm's in ankle so i end up having 10 mm difference and i started having noticeable imbalance and back pain when doing sports like football and squat in gym.

Do u have any discrepancy ? or aiming for texture lengthening ?

I'm looking to get confirmation (or not) on whether I have any significant LLD by an orthopedist. I have obvious scoliosis. I'm measurably taller standing on one leg than on the other. But that could be due to other reasons, too. I will be getting it checked.

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Formerly myloginacct; had issues with my login account.
Yes I do want to add, before doing this surgery, ask yourself if you have optimized your life to the fullest extent possible (job/career, personality, etc).

Hamza

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Re: Small LLD correction with Dr. Rozbruch
« Reply #8 on: August 12, 2018, 08:20:40 PM »

I'm looking to get confirmation (or not) on whether I have any significant LLD by an orthopedist. I have obvious scoliosis. I'm measurably taller standing on one leg than on the other. But that could be due to other reasons, too. I will be getting it checked.

Best of luck !!
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Body Builder

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Re: Small LLD correction with Dr. Rozbruch
« Reply #9 on: August 12, 2018, 11:39:21 PM »

For 1cm in tibias and femurs you need Stryde or any kind of internal LL nail?
Can't your doctor make a gap of 4-5mm in each bone and fix them with an internal nail (not for lengthening) and then have the bone consolidate slowly to bridge the gap?
I don't think that 4-5mm are so much to have a malunion.
Using 2 strydes for 1cm discrepancy (0.5mm in tibias and 0.5mm in femurs) is really too much imo.
After all it would be much easier and cheaper to shorten 1cm your other leg. It won't cause you amy problem and in less than a month you'll be completely ok.
I don't know any doctor using 2 internal LL nails just to fix 1cm discrepancy.
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Hamza

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Re: Small LLD correction with Dr. Rozbruch
« Reply #10 on: August 13, 2018, 05:22:49 AM »

For 1cm in tibias and femurs you need Stryde or any kind of internal LL nail?
Can't your doctor make a gap of 4-5mm in each bone and fix them with an internal nail (not for lengthening) and then have the bone consolidate slowly to bridge the gap?
I don't think that 4-5mm are so much to have a malunion.
Using 2 strydes for 1cm discrepancy (0.5mm in tibias and 0.5mm in femurs) is really too much imo.
After all it would be much easier and cheaper to shorten 1cm your other leg. It won't cause you amy problem and in less than a month you'll be completely ok.
I don't know any doctor using 2 internal LL nails just to fix 1cm discrepancy.

Body Builder, Just a small clarification:

1- Dr. Rozbruch will do me femur lengthening only of 10 mm  and he will not touch the tibia and he will try to use STRYDE in order to be able to walk earlier without crutches. One of the reasons of not touching the tibia is that it is a small discrepancy as u have just said and it can be all corrected from femur which is much easier and faster to recover.

2- 10 mm in one shot might give some complications so he prefers to go slowly even though the case is much easier

3- shortening the longer leg was not an option

Can u tell me a bit about ur medical case ?

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Body Builder

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Re: Small LLD correction with Dr. Rozbruch
« Reply #11 on: August 13, 2018, 03:17:49 PM »

Body Builder, Just a small clarification:

1- Dr. Rozbruch will do me femur lengthening only of 10 mm  and he will not touch the tibia and he will try to use STRYDE in order to be able to walk earlier without crutches. One of the reasons of not touching the tibia is that it is a small discrepancy as u have just said and it can be all corrected from femur which is much easier and faster to recover.

2- 10 mm in one shot might give some complications so he prefers to go slowly even though the case is much easier

3- shortening the longer leg was not an option

Can u tell me a bit about ur medical case ?
I just did LL.
5 years after I did a right tibia malunion correction which lead to about 3-4mm gap on one side of the tibia (to make the bone straight) and I had a plate inside to keep it stable. In about 3 weeks I was fully wight bearing and in a few months ( 3-4) the bone was fully consolidated.

Doing 1cm on femur and fixing the discrepancy by making one femur longer than the other I don't know if it is completely right. But Rozbruch is a respectable doctor so I think he knows what he is doing.
If I was you I'd definitely shorten the longer leg or shorten just 0.5mm the tibia and have only a 0.5mm discrepancy which is considered normal and cause no problems.
Having an internal nail wouldn't be my choice for a so minor discrepancy. But your doctor knows better than me.
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Purushrottam

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Re: Small LLD correction with Dr. Rozbruch
« Reply #12 on: August 14, 2018, 03:13:25 AM »

I just did LL.

What? Did you just do a second LL? Did you make a diary for it?
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Hamza

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Re: Small LLD correction with Dr. Rozbruch
« Reply #13 on: August 14, 2018, 06:45:18 AM »

I just did LL.
5 years after I did a right tibia malunion correction which lead to about 3-4mm gap on one side of the tibia (to make the bone straight) and I had a plate inside to keep it stable. In about 3 weeks I was fully wight bearing and in a few months ( 3-4) the bone was fully consolidated.

Doing 1cm on femur and fixing the discrepancy by making one femur longer than the other I don't know if it is completely right. But Rozbruch is a respectable doctor so I think he knows what he is doing.
If I was you I'd definitely shorten the longer leg or shorten just 0.5mm the tibia and have only a 0.5mm discrepancy which is considered normal and cause no problems.
Having an internal nail wouldn't be my choice for a so minor discrepancy. But your doctor knows better than me.

I asked the DR. about knee alignment after lengthening the right femur by 10 mm while i have 5 mm in femur and 5 mm in tibia and he said it will not be an issue as the discrepancy is small and cutting 2 bones for just 10 mm is not an option.

I just want to be sure that i got ur idea "Body Builder", did u mean that correcting just 5 mm from femur or tibia and leave the other 5 mm without correction would be better than correcting the whole 10 mm from femur side ?

Note that i have a very mild CMT1 (Charcot Marie Tooth Disease) which results me in a mild muscular dystrophy (weakness in legs muscles) that specially affected my tibial muscles (shorter leg tibial muscle is weaker) and this is one of the main reasons that just 10 mm of discrepancy is resulting me in imbalance and back pain

When I modify my right side shoe by cutting the out-sole by AMERICAN HEELERS orthopedic center and inserting as little as 7 mm full out-sole i can feel like 80% more balance with no back pain and i can play all sports.
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Body Builder

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Re: Small LLD correction with Dr. Rozbruch
« Reply #14 on: August 14, 2018, 02:29:07 PM »

What? Did you just do a second LL? Did you make a diary for it?
No, I meant that I only did LL.
Forgive my language faults, english is not my native language.
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Body Builder

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Re: Small LLD correction with Dr. Rozbruch
« Reply #15 on: August 14, 2018, 02:33:24 PM »

I asked the DR. about knee alignment after lengthening the right femur by 10 mm while i have 5 mm in femur and 5 mm in tibia and he said it will not be an issue as the discrepancy is small and cutting 2 bones for just 10 mm is not an option.

I just want to be sure that i got ur idea "Body Builder", did u mean that correcting just 5 mm from femur or tibia and leave the other 5 mm without correction would be better than correcting the whole 10 mm from femur side ?

Note that i have a very mild CMT1 (Charcot Marie Tooth Disease) which results me in a mild muscular dystrophy (weakness in legs muscles) that specially affected my tibial muscles (shorter leg tibial muscle is weaker) and this is one of the main reasons that just 10 mm of discrepancy is resulting me in imbalance and back pain

When I modify my right side shoe by cutting the out-sole by AMERICAN HEELERS orthopedic center and inserting as little as 7 mm full out-sole i can feel like 80% more balance with no back pain and i can play all sports.
Yes, I think that doing 0.5-0.6mm femur LL will be better than having equal length of legs but with 1cm added to your femur.
I would equal my femurs (or tibias) and would leave about 0.5cm shorter the other segment.
I think that it will be better. But I am not 100% sure. But even what Rozbruch says will be better than now, thats for sure.
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Hamza

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Re: Small LLD correction with Dr. Rozbruch
« Reply #16 on: August 16, 2018, 07:18:12 AM »

Yes, I think that doing 0.5-0.6mm femur LL will be better than having equal length of legs but with 1cm added to your femur.
I would equal my femurs (or tibias) and would leave about 0.5cm shorter the other segment.
I think that it will be better. But I am not 100% sure. But even what Rozbruch says will be better than now, thats for sure.

According to the DR. Using Precise nail 2 instead of lengthening in one shot is just because it is much more accurate specially that i have a small discrepancy.

The Dr. prefer to correct it all from femur and said that knee difference is not an issue for such a small amount, but at the same time he asked me to try insoles starting from 7 to 10 mm (I have been trying insoles and out soles since more than 10 years :)) and decide which level is better for me. I will go with the least level that my body can adapt to and it is 7 mm and this is close to ur point of view.
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Hamza

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Re: Small LLD correction with Dr. Rozbruch
« Reply #17 on: August 16, 2018, 07:38:14 AM »

Dr. Rozbruch said it is a bit early to use STRYDE as it shows minor problems and the company is still working on. I will be doing the Precise nail 2 (6-8 weeks on crutches).

My surgery is next week.
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Body Builder

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Re: Small LLD correction with Dr. Rozbruch
« Reply #18 on: August 16, 2018, 09:40:30 AM »

According to the DR. Using Precise nail 2 instead of lengthening in one shot is just because it is much more accurate specially that i have a small discrepancy.

The Dr. prefer to correct it all from femur and said that knee difference is not an issue for such a small amount, but at the same time he asked me to try insoles starting from 7 to 10 mm (I have been trying insoles and out soles since more than 10 years :)) and decide which level is better for me. I will go with the least level that my body can adapt to and it is 7 mm and this is close to ur point of view.
Good choice.
Also, precise 2 for such a small lengthening is no big deal. You'll wal nsoon enough, maybe in about a month.
Keep us informed.
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Hamza

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Re: Small LLD correction with Dr. Rozbruch
« Reply #19 on: August 16, 2018, 11:42:32 AM »

Good choice.
Also, precise 2 for such a small lengthening is no big deal. You'll wal nsoon enough, maybe in about a month.
Keep us informed.

Sure I will
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