Butterflied fractures

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Below are X-rays of my tibias at different stages post implantation of the PRECICE 2.2. As you can see in the first image (zoom in if you need to), the bone break is far from a clean cut - there's a triangular bone chip. Definitely not what I expected to see.

When I asked Dr. Robbins (Paley's colleague) about this in April, he said it's actually a new bone breaking technique, designed to increase the bone surface around the break, for increased bone generation. However, this is at odds with Paley describing how to avoid butterfly in his January talk ("I guarantee that there's no butterfly").

Thoughts?

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That's very interesting. It looks like the fracture on the right side is V shaped which makes sense for surface area. I'm guessing that's what they were attempting on the left side but then that chip broke off. Hopefully by your next x-ray that chip will be fused to one side of the bone or the other.

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Hmm. Maybe Dr. Paley was describing how to prevent butterfly, not necessarily advocating that it's the best osteotomy method. That case was from 2012 after all, techniques and the philosophies behind them evolve over time.

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I always wonder how the bones that are not aligned will grow together. Will it look like this?

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Quote from: LLprime2 on May 14, 2018, 10:24:45 PMI always wonder how the bones that are not aligned will grow together. Will it look like this?


Isn't there a device they use for correction? From my understanding a slight mm shift in being crooked is common place in humans and shouldn't matter as much regardless.

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Quote from: LLprime2 on May 14, 2018, 10:24:45 PMI always wonder how the bones that are not aligned will grow together. Will it look like this?




Not quite.

Since the bone segments get farther and farther from each other, the ensuing gap becomes more and more "vertical" (in the typical x-ray orientation). Here's how that gap looked on June 8 (7 weeks of lengthening the tibias, 4 weeks since stopping lengthening):