Quote from: Smallguy on January 12, 2014, 05:44:24 AMI hope we are on the same page. Yes, your leg is lengthened. If you distract say, 7cm, then your leg is technically longer by 7cm because the gap where the bone is broken is widen by 7cm. Some people would say that would not be an accurate reflection of your height because you are not standing up. But I'm not going into that sort of detail. I say give or take 7cm.
Because the pin and the frame are not perfect, it won't be able to bear your full weight. When the patient has say, 7cm, and he stands up, his full weight compresses down on the metal frame that holds the tibias together and bending the pin. And when the pin bends, it compresses down on the gap. Thus, the patient loses the 7cm. That's my idea. And I have witness many patients who have lost height (or the gap) this way.
Why this gap is so important? Because your gain is only millimeters per day. Sometime you have stay for 4 months for 8cm if you're lucky. And every day when you wear the metal frame, it's a living hell. The pin constantly cuts through your flesh. You feel all sort of pain. And it's highly comfortable to sleep with. The pain of external LL is the worst. Patients fail to achieve their desirable gain, not because of surgical complications... Most of the time, you can wait out your complications. For example, if you have nerve issue like Asoka or lack of callus, you can wait out until your nerve comes back or your callus is better formed... but patient fail because they cannot bear the pain. So my idea is to lengthen asap and achieve your desirable height. That's what you come there for in the first place. Then once the frame is removed, then you can focus on your recovery.
I know a lot of guys who have never experienced LL will disagree with me on this one. They would say, long term recovery is just as equally important as height gain. If you rush you risk damaging your soft tissue, etc But if every day of your life has been a living hell for the past 4 months, the pin is cutting through your flesh and giving you constant pain... and you already paid a fortune for this surgery, then I say it's okay to try to get your goal achieved quickly and get this over with.
This was my experience in India.
There is no accurate way to measure your gap using the Indian x-ray. I usually minus 5mm just in case. The x-ray at Sarin's hospital is more high tech. He uses that one to determine how much the patient has gained. That was the one that I and Sweden were used to determine how much we gained. I don't know how Sangari's patient or other doctors measure their patient.
To be honest i agree with you, I also would prefer to get it done as soon as possible (lengthening fast with double cut) so i can return home as fast as possible even if it means i will take a bit longer to recover 100% in terms of nerves and soft tissue.
If standing up reduces the risk of the gap closing from the body weight, then i will probably lay in bed for most of the lengthening phase. In my case only lengthening 4 cms means i wouldnt have to lay in bed for that long, so i probably wont lose to much muscle strenght anyway.
But arent the external frames supposed to be stable enought to keep the bones steady in place, preserving the gap? I guess there is some sort of weight limit that it can withstand. I weight like 64 Kilos only so they should be able to hold that weight without losing height gain.
But after lengthening phase is over, and you are in consolidation phase, is there still a risk of losing height by just standing up and walking? I cant imagine having to lay down for like 4 months total, i cant think of any other patients that did that. I mean during consolidation phase I assume there would already be solid callus on the outer part of the bones, keeping the bone from compressing, while the inner part of the bone keeps healing until it is strong enough to carry the body weight again without the frame.
Not sure if we are on the same page, maybe i misunderstood you.
But Dr. Mirzoyan unlike those indian doctors, has a set price per cm, so if you pay him for a certain length it should be his responsibility to assure the patient he got the height he paid for, at least thats what im going to tell him when i meet him.
Plus, in the early phase, you need to take into account of ballerina when you measure yourself. Of course, your height will be less as your heel becomes flat to the floor.