It's quite possible I'll be wearing the frames for a whole year, based on Dr Parihar's response to my last set of x-rays. He's not in agreement with my local orthopedist about removing the frames and putting me in walking braces in mid-April.
i have seen the X-rays.
they show progress. since the nuts have been loosened only on this visit, i would expect to see the improvement due to that only on the next set of X-rays.
removal of frames:
i usually remove the frames only when i can see corticalisation of at least 3 out of 4 sides of the bone - (medial cortex and lateral cortex are seen on the AP X-ray, and anterior and posterior cortex on the lateral X-ray)
in patients who have a nonunion etc, the leg can be protected in a brace after fixator removal. in patients who have a long regenerate (as in your case 6 cms), i believe that the risk of refracture or bending of the regenerate is too high to trust a brace, unless the 3 cortex sign as mentioned above is present.
as i may have told you at the initial consult.
- a month too late is better than a day too early.
- the consolidation phase is when the most patient patient becomes impatient, and i think i can ascribe the lesser number of complications that we have to the fact that i am able to resist patient pressure to take off the frame, before i am convinced that it is ready for removal, based on my clinical and X-ray findings, rather than on patients feelings or discomfort.
feel free to share this with your local orthopedist.
No More Mal-Kahn-Tent - External Tibias - Dr Parihar
sux to wear the frames...
but if you take off too early, you might need to get leg rebroken again and wear a frame anyway... there's just no way of getting around the long time frame with external fixation
and after a year, you'll not be walking normally right after they come off
this whole process takes a while
Hey Kilo,
Great diary so far! I am still undecided when it comes to the method of lengthening (LON\external). How do the frames affect your daily life? Are you able to do stuff like buying grocceries or just take a stroll?
The frames are sometimes not a bother at all and sometimes a real pain in the ass. The longer you wear them, the more the pin sites slowly open up due to skin stretching and movement, and the more uncomfortable wearing them gets on average in a day. Right now I'm back to having a lot of difficulty sleeping without taking pills before bed. I don't think I'd be able to go grocery shopping with them on considering how slow I walk, plus I probably wouldn't be able to carry much while having to grip on to the walker. If you have a wheelchair you can get around fine so long as you have someone to drive you to your destinations.
Exfix is certainly more uncomfortable long term than LON, but I did it to avoid the possibility of chronic knee problems that comes with insertion of the nail into your tibias.
Hey Kilokahn,
Being in external fixators ,for one year, is a long time. Hang in there. You are almost there. When it comes to LL, I would rather be safe than sorry. Good luck to you.
Here's what my walking looks like now. I still have a tendency to lean forward while walking but it's getting better.
Quote from: KiloKAHN on March 24, 2015, 09:51:42 PMHere's what my walking looks like now. I still have a tendency to lean forward while walking but it's getting better.
Looks awesome man! I don´t see anything wrong with your walking, it´s just a little slower.
Do you think you could use crutches instead of a walker, I´d feel a little weird using a walker in public (like an old man 
).
Keep us updated, I really appreciate your diary it´s so detailed and well written. This is definitely one of the most valuable sources available for future patients.
I must say that your tibias look very good, not disproportionate at all!
Looks great and natural. Your proportion seems to be better now as lengthening your lower legs have balanced out your wider upper body. LL definitely benefited you. Without the frame, I wouldn't be able to detect that you have done LL.
With the external frames though, I would be careful of x-leg or knee knock. That seems to be a common occurrence both in India and Russia. But I'm sure Dr. Parihar is a great doctor and I just want to put this out so you are aware of it and prevent it from happening. Cheers.
KiloKAHN, your proportions look phenomenal. And your walking is really coming along. Great job bro!
i dont feel so bad about my walking now... external fixation when you do 6- 8 c simply takes forever to recover from
kilo... the odds are you wont be walking normally without any assistance until more than a year after surgery...same thing for me
did you expect this or has the duration surprised you??
i think those considering having external fixation should pay attention.... especially if youre doing 7 or more cm....it will realistically take over a year to function somewhat normally without any walking aid
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