Ouch (possible NSFW pictures of my rear to follow)

Ouch (possible NSFW pictures of my rear to follow)

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Dibble

Original Poster:

12,938 posts

241 months

Wednesday 27th November 2019
quotequote all
Yep, I’ll have to see what the options are. On the plus side, I’m probably Britain’s least fashionable person, so a spacky looking sure will e neither here nor there for me!

It’s a good point about the cranks and I’m sure my pushbike owning mate can easily swap it over if it needs it. Fortunately, where I live it’s pretty flat - not quite “Dutch flat”, but not a million miles off it, so I might well get away with odd cranks (not a euphemism).

I’ve finished at the dentist, so now I’m treating myself to a couple of pints in my mate’s bar and I’ll be having an early chippy tea in an hour or so, before heading home to watch some rubbish on Netflix with the idiot dog. Don’t tell me I don’t know how to live!

Big_Dog

974 posts

186 months

Wednesday 27th November 2019
quotequote all
I had a similar set of challenges 10 years ago, femur in 20 bits and hip in 3. I have my right leg 25mm shorter than my left. I use: https://www.dorset-ortho.com/en/
Can't recommend them enough. I saw their orthotist and they make the necessary shoe adjustments too. Shoes are C£70
Make sure you get that leg length measured correctly, it's not easy. Mine was wrong for 2 years, now need a new hip.

2wheelsjimmy

620 posts

98 months

Wednesday 27th November 2019
quotequote all
To chime cycling, the best thing is cycling specific shoes and a big wedge underneath, or if on a static indoor bike, cut some timber to the right height and tape it to the pedal. Anything else could cause increased stress and muscle recruitment discrepancy. A good bike fitter will be able to help with this.

Edit: I remember Speedplay also released a cleat that has the shim built it (makes walking off bike easier). https://bikerumor.com/2016/10/04/ib16-speedplay-sy...

As said above, different crank lengths is really un-ideal. And lowering the saddle to accommodate the short leg, will create issues with the long leg.

I've been informed that the real way to measure leg length is via an MRI. Anything else is a guess.

I am sure the physios you have access to will be able to give professional guidance.

Edited by 2wheelsjimmy on Wednesday 27th November 15:23

WinstonWolf

72,857 posts

240 months

Wednesday 27th November 2019
quotequote all
Big_Dog said:
I had a similar set of challenges 10 years ago, femur in 20 bits and hip in 3. I have my right leg 25mm shorter than my left. I use: https://www.dorset-ortho.com/en/
Can't recommend them enough. I saw their orthotist and they make the necessary shoe adjustments too. Shoes are C£70
Make sure you get that leg length measured correctly, it's not easy. Mine was wrong for 2 years, now need a new hip.
I've had 2" missing for thirty five years, all I use is a heel raise that removes about 3/4" of the discrepancy and I'm still mostly fine. No back or hip trouble to speak of thumbup

The one thing I've done since I got smashed up is exercise like it's going out of fashion. Weight is a killer, you can't afford to carry any real excess with odd length legs!

tvrolet

4,285 posts

283 months

Wednesday 27th November 2019
quotequote all
Dibble said:
I’m now consistently maintaining a 100° bend in my knee, but seem to have stalled a bit at that angle. The physio explained that might be as good as it gets (worst case scenario), but they can’t really do much more “forcing” it to bend until I’m fully weight bearing, which I’m still hoping will be just before Christmas.
Feet-forward cruiser style bike it is then wink

Re physios though, I found they set your aspirations really low - maybe just the few I've had but it seems a trained-in thing. Maybe it so as not to disappoint folks who don't put the work in. Nowhere in the same league as your injury, but my physos (plural) for a snapped achilles tendon was to 'aim just to walk without a limp'. I said hell no, I wanted to run. jump, skip, hop, ski and be perfectly normal again but that was suggested to be aiming a bit high. But having put the time in there was no lasting problems. I did my tib and fib in France and the French surgeon was confident I'd be normal and skiing in 9 months. Back in the UK and the physio was suggesting anything much more than walking was a step too far in the short term. I was skiing again in 6 months. I think a lot of the advice is based on 'old' people (hell, I'm old now) who don't put in the hours or push the pain.

Good luck with it all smile

FiF

44,181 posts

252 months

Wednesday 27th November 2019
quotequote all
Dibble said:
The doctor was quite surprised when I said I hoped I would be able to get back to being fully operational...
Not trying whatsoever to Elevenerife you Dibs but can relate to that. I was off with hypersensitive pneumonitis, caused we believed by getting a good few lungfuls of some pretty nasty chemical laden dust when breathing apparatus got knocked off. At one point I was 1% off going onto the transplant list, and works doctor and my consultant had virtually agreed to sign me off on disability insurance and then pension but eyebrows were raised when adamant going to beat it and get back to work. Eventually did and got another eight years in. In hindsight maybe was stupid, some of those 8 years hurt.

Anyway good luck and well done for fighting it. 2 and a half years, makes my issues look like nowt.

Dibble

Original Poster:

12,938 posts

241 months

Friday 13th December 2019
quotequote all
Well, I saw the consultant again today and there was quite a bit of good news. Then there was what I’m going to refer to as “other news”. Positive thinking and all that.

So, the good news: I had a full leg length X-ray done today and I’m pleased to say I now have an actual, honest to god, rebuilt, functioning femur - or about 95% of one. There is still a bit more maturing/hardening of the regenerate (new bone) to go, at the top of my femur, where the lengthening took place after the osteotomy (surgical break). The slight infection from a few weeks ago has stayed under wraps, but is still under review if it rears its ugly, buggy head again.

More good news: I can now weight bear 100%, even through the new bone is still settling down/hardening. Actually using the leg/bone will in fact help with the final bit of healing. I’m allowed to use one crutch inside, two crutches outside and I’m allowed to drive again, which is going to be a huge help. I can’t actually walk without at least one crutch, not yet, anyway.

When I was at physio on Wednesday, the delightful physio told me she “couldn’t wait” to get the go ahead and “start properly working” me. I’m less enthusiastic about this prospect than she is, I suspect. I’m slowly building my glutes and quads back up, relearning to “switch” them on and off to walk/do leg stuff. I’ve got some exercises to do, which seem simple, but are pretty tiring, pretty quickly, but that at least shows I’m exercising the right bits.

Being 100% weight bearing means I can also get my application in for the residential rehab at the Police Treatment Centre in Harrogate - if any PH BBers are around when I’m there, I’ll happily come and meet you for a pint or two (although there is a midnight curfew to be back on site). Hopefully I’ll be there early in the New Year, either late January or early February.

The join at the “knee end” is now fully healed, although there are a few odd bits of bone growing around the join, but they should even themselves out a bit. Because the last alignment I had was right at the limits of the frame, they couldn’t quite get my leg as exactly straight/positioned as intended. This isn’t a biggie, it just means that when I lie on my right hand side, because there’s not much muscle there at the moment and quite a bit of scar tissue, I can feel my bone close to the surface. This sensation should reduce, as the muscles get back to normal.

For now, the rogue pin is staying in my knee. My consultant is still of the view that it’s not the cause of the infection and “ferreting about in there and digging it out” (her words) risk doing more harm than good. Again, that is subject to review and will depend on whether or not any more infections appear. If they do, Pinny Pinster might well see the light of day again. I’ve still got the metal plates and pins across the front of my pelvis and again, barring them being an infection host, they’re staying put as well (that was always the plan anyway).






What? The “Other News”? Ah. Yes. Right. Weeeeeellllll...

Remember the not-quite-aligned-just-how-it-was-planned bit at the top of my femur? That, and the really bad infections, meaning a wholesale revision of “Plan A” last summer? My right femur is 28 millimetres (or just over an inch and an eighth for those viewing in black and white and listening in mono) longer than my left femur. This means my knees and ankles are misaligned.

I’ve already been referred to the orthotics people, to start off with an insole, but I’m probably going to need my right shoe to be built up on the sole. Stylish... What this all boils down to is that the consultant isn’t happy with the end result, as far as bone lengths go. She’s happy with the healing and function, just not the length (oo-er, Matron). There are three surgical options to deal with this:

  • Option one: lengthen my right femur by 15-20mm. The way it’s already been done, once I’ve got full use of the leg back, in 6-12 months, so another external lateral femoral rail. Eff eff ess. Pros are it’ll be a lot quicker than 18 months and they’ve already pissed about with that leg, so I won’t get any extra scars and my knees and ankles will be back “level”. Cons? Lateral femoral rail, infection risk, length of time to recover (when the frame comes off, I’ll have to go toe touch - 50% - 75% - full weight bearing. Oh, and it’s a good job I kept the “zippy leg jeans”, rather than chucking them out...
  • Option two: lengthen my right tibia and fibula by 15-20mm. Pros... erm, let me get back to you on that one. Cons? Halo/Ilizarov frame and two skinny, yet complicated, bones to break and heal. My legs overall will be about the same length, but one knee will be higher than the other. Not ideal.
  • Option three: shorten my left femur by 15-20mm, by taking out a “Polo mint” section of my femur, inserting an intramedullary nail in my femur, the. Sticking the two cut ends of the bone together where the section has been removed. Pros are that this is the quickest route, surgery to recovery, and I’d be able to weight bear a lot sooner. It also means my knees and ankles would be correctly aligned. Cons are I’d be shorter in height by 15-20mm (although obviously this will make my cock look much longer, so there’s that...). It also means pissing about with a leg that so far is in perfect nick (it’s all relative). And if I get infections again, either around the IM nail or at the docking site, it could potentially jeopardise my whole leg...
I wasn’t expecting to hear these options at all today. I just expected a referral to orthotics and to have to get on with odd leg lengths for the rest of my life, so there’s a bit of thinking to be done over the next few months. For now, I’m going to enjoy being able to drive and therefore take The Idiot to the secure dog walking field. I’m also going to enjoy Christmas and New Year with my GF, then get myself to Harrogate as soon as possible and get fitter/stronger. I’m going to see how I get on with the difference in leg lengths once I’m walking without crutches or a stick, then have another think about what the best option is, whether that be one of the three possible surgeries, or just being permanently lopsided.

I also want to do a bit of travelling, just the odd weekend here and there and I’d also like to get out of the rental flat I’m currently in and into a place of my own, so I can start paying off a mortgage. Then of course, there’s motorbike shopping to consider...

Anyway, sorry for yet another lengthy post in the seemingly never-ending saga of Leggy McLegster. I’ll leave it there for now, but feel free to fire away if anyone has any questions. Other than that, I hope everyone has a great weekend.

Benni

3,517 posts

212 months

Saturday 14th December 2019
quotequote all
Congrats to your healing progress, and thanks for the updates.
I would go the shoe way, much easier and less risk than the op shenanigans.
You might have to change your nick to Goebble, though.

Dibble

Original Poster:

12,938 posts

241 months

Saturday 14th December 2019
quotequote all
Benni said:
Congrats to your healing progress, and thanks for the updates.
I would go the shoe way, much easier and less risk than the op shenanigans.
You might have to change your nick to Goebble, though.
Cheers, Benni, I appreciate your comments.

It’s not quite as simple as “just a shoe”, that’s the issue. Not doing something could lead to permanent injury/disability down the line, meaning hip/knee replacements (I might need those anyway, as would anyone, I just might need them sooner and/or more often).

I don’t have to worry about it at all for now, that’s one good thing. Another is that I completely trust my consultant, no matter how utterly bonkers she is (absolutely hatstand). So if she thinks it needs doing and is worth doing, I’d be happy to go with her professional opinion.

Ultimately, any decision is mine. I’ve already had a chat about it with my GF and she’s made some good points I hadn’t considered (like perhaps messing with an as yet undamaged limb isn’t necessarily the best option, even though lengthening again will be a right pain). There isn’t a perfect, one size fits all answer unfortunately - like many things in life, it might well be a case of picking the “least worst” option.

The other bit of good news I forgot to mention is that the pain is definitely under control. I’m no longer getting any sort of sciatic pain and I’m already reducing the various medications, with a view to being able to stop taking them all in a few weeks. The biggest worry is the OxyCodone - there are lots of issues about coming off that, particularly after being on it for 18 months. I’m basically the world’s sttest heroin addict...

black-k1

11,939 posts

230 months

Saturday 14th December 2019
quotequote all
Definite progress and great news. Long may it continue.

Bobberoo99

38,776 posts

99 months

Saturday 14th December 2019
quotequote all
You've come so far and been through so much Dibble, it's time to have break (no pun intended) enjoy Christmas and New Year with lovely GF and get yourself fitter and stronger, then you can make your decision, for now push it to the back of your mind and enjoy getting around and having some freedom!!!

Krikkit

26,555 posts

182 months

Saturday 14th December 2019
quotequote all
Great news Dibble, sounds like you're coming on nicely.

The surgery is a st bit of news, but as you say, that's one to percolate on. As a fence sitter I think I know what I'd go for, but that's without ever having had surgery, never mind the absolute nightmare you've had with infections etc.

tr7v8

7,199 posts

229 months

Saturday 14th December 2019
quotequote all
Fantastic to hear Dibble. Been following as a lurker since it happened & despite the setbacks great that you're on the home straight.

FrenchCarFan

6,759 posts

206 months

Saturday 14th December 2019
quotequote all
Dibble said:
Benni said:
Congrats to your healing progress, and thanks for the updates.
I would go the shoe way, much easier and less risk than the op shenanigans.
You might have to change your nick to Goebble, though.
Cheers, Benni, I appreciate your comments.

It’s not quite as simple as “just a shoe”, that’s the issue. Not doing something could lead to permanent injury/disability down the line, meaning hip/knee replacements (I might need those anyway, as would anyone, I just might need them sooner and/or more often).

I don’t have to worry about it at all for now, that’s one good thing. Another is that I completely trust my consultant, no matter how utterly bonkers she is (absolutely hatstand). So if she thinks it needs doing and is worth doing, I’d be happy to go with her professional opinion.

Ultimately, any decision is mine. I’ve already had a chat about it with my GF and she’s made some good points I hadn’t considered (like perhaps messing with an as yet undamaged limb isn’t necessarily the best option, even though lengthening again will be a right pain). There isn’t a perfect, one size fits all answer unfortunately - like many things in life, it might well be a case of picking the “least worst” option.

The other bit of good news I forgot to mention is that the pain is definitely under control. I’m no longer getting any sort of sciatic pain and I’m already reducing the various medications, with a view to being able to stop taking them all in a few weeks. The biggest worry is the OxyCodone - there are lots of issues about coming off that, particularly after being on it for 18 months. I’m basically the world’s sttest heroin addict...
Coming off the opiates is definitely worth it.

I guess you'll be very dependent on them now and may find it difficult. I weaned myself off the gabapentin and amitriptyline ASAP as I was intent on returned to work and I simply wouldn't be allowed to work on them. Good to see progress updates.

NNH

1,520 posts

133 months

Saturday 14th December 2019
quotequote all
Best wishes with your decisions. Have you considered option 4: lengthen both legs, enjoy life at a new altitude wink

GM182

1,271 posts

226 months

Sunday 15th December 2019
quotequote all
Bobberoo99 said:
You've come so far and been through so much Dibble, it's time to have break (no pun intended) enjoy Christmas and New Year with lovely GF and get yourself fitter and stronger, then you can make your decision, for now push it to the back of your mind and enjoy getting around and having some freedom!!!
Well said.

You've been through the mill alright. I'm sure you'll make the decision that's right for you.

Much respect for your positivity and resilience.


WinstonWolf

72,857 posts

240 months

Monday 16th December 2019
quotequote all
Dibble said:
Well, I saw the consultant again today and there was quite a bit of good news. Then there was what I’m going to refer to as “other news”. Positive thinking and all that.

So, the good news: I had a full leg length X-ray done today and I’m pleased to say I now have an actual, honest to god, rebuilt, functioning femur - or about 95% of one. There is still a bit more maturing/hardening of the regenerate (new bone) to go, at the top of my femur, where the lengthening took place after the osteotomy (surgical break). The slight infection from a few weeks ago has stayed under wraps, but is still under review if it rears its ugly, buggy head again.

More good news: I can now weight bear 100%, even through the new bone is still settling down/hardening. Actually using the leg/bone will in fact help with the final bit of healing. I’m allowed to use one crutch inside, two crutches outside and I’m allowed to drive again, which is going to be a huge help. I can’t actually walk without at least one crutch, not yet, anyway.

When I was at physio on Wednesday, the delightful physio told me she “couldn’t wait” to get the go ahead and “start properly working” me. I’m less enthusiastic about this prospect than she is, I suspect. I’m slowly building my glutes and quads back up, relearning to “switch” them on and off to walk/do leg stuff. I’ve got some exercises to do, which seem simple, but are pretty tiring, pretty quickly, but that at least shows I’m exercising the right bits.

Being 100% weight bearing means I can also get my application in for the residential rehab at the Police Treatment Centre in Harrogate - if any PH BBers are around when I’m there, I’ll happily come and meet you for a pint or two (although there is a midnight curfew to be back on site). Hopefully I’ll be there early in the New Year, either late January or early February.

The join at the “knee end” is now fully healed, although there are a few odd bits of bone growing around the join, but they should even themselves out a bit. Because the last alignment I had was right at the limits of the frame, they couldn’t quite get my leg as exactly straight/positioned as intended. This isn’t a biggie, it just means that when I lie on my right hand side, because there’s not much muscle there at the moment and quite a bit of scar tissue, I can feel my bone close to the surface. This sensation should reduce, as the muscles get back to normal.

For now, the rogue pin is staying in my knee. My consultant is still of the view that it’s not the cause of the infection and “ferreting about in there and digging it out” (her words) risk doing more harm than good. Again, that is subject to review and will depend on whether or not any more infections appear. If they do, Pinny Pinster might well see the light of day again. I’ve still got the metal plates and pins across the front of my pelvis and again, barring them being an infection host, they’re staying put as well (that was always the plan anyway).






What? The “Other News”? Ah. Yes. Right. Weeeeeellllll...

Remember the not-quite-aligned-just-how-it-was-planned bit at the top of my femur? That, and the really bad infections, meaning a wholesale revision of “Plan A” last summer? My right femur is 28 millimetres (or just over an inch and an eighth for those viewing in black and white and listening in mono) longer than my left femur. This means my knees and ankles are misaligned.

I’ve already been referred to the orthotics people, to start off with an insole, but I’m probably going to need my right shoe to be built up on the sole. Stylish... What this all boils down to is that the consultant isn’t happy with the end result, as far as bone lengths go. She’s happy with the healing and function, just not the length (oo-er, Matron). There are three surgical options to deal with this:

  • Option one: lengthen my right femur by 15-20mm. The way it’s already been done, once I’ve got full use of the leg back, in 6-12 months, so another external lateral femoral rail. Eff eff ess. Pros are it’ll be a lot quicker than 18 months and they’ve already pissed about with that leg, so I won’t get any extra scars and my knees and ankles will be back “level”. Cons? Lateral femoral rail, infection risk, length of time to recover (when the frame comes off, I’ll have to go toe touch - 50% - 75% - full weight bearing. Oh, and it’s a good job I kept the “zippy leg jeans”, rather than chucking them out...
  • Option two: lengthen my right tibia and fibula by 15-20mm. Pros... erm, let me get back to you on that one. Cons? Halo/Ilizarov frame and two skinny, yet complicated, bones to break and heal. My legs overall will be about the same length, but one knee will be higher than the other. Not ideal.
  • Option three: shorten my left femur by 15-20mm, by taking out a “Polo mint” section of my femur, inserting an intramedullary nail in my femur, the. Sticking the two cut ends of the bone together where the section has been removed. Pros are that this is the quickest route, surgery to recovery, and I’d be able to weight bear a lot sooner. It also means my knees and ankles would be correctly aligned. Cons are I’d be shorter in height by 15-20mm (although obviously this will make my cock look much longer, so there’s that...). It also means pissing about with a leg that so far is in perfect nick (it’s all relative). And if I get infections again, either around the IM nail or at the docking site, it could potentially jeopardise my whole leg...
I wasn’t expecting to hear these options at all today. I just expected a referral to orthotics and to have to get on with odd leg lengths for the rest of my life, so there’s a bit of thinking to be done over the next few months. For now, I’m going to enjoy being able to drive and therefore take The Idiot to the secure dog walking field. I’m also going to enjoy Christmas and New Year with my GF, then get myself to Harrogate as soon as possible and get fitter/stronger. I’m going to see how I get on with the difference in leg lengths once I’m walking without crutches or a stick, then have another think about what the best option is, whether that be one of the three possible surgeries, or just being permanently lopsided.

I also want to do a bit of travelling, just the odd weekend here and there and I’d also like to get out of the rental flat I’m currently in and into a place of my own, so I can start paying off a mortgage. Then of course, there’s motorbike shopping to consider...

Anyway, sorry for yet another lengthy post in the seemingly never-ending saga of Leggy McLegster. I’ll leave it there for now, but feel free to fire away if anyone has any questions. Other than that, I hope everyone has a great weekend.
Don't stress the odd length leg thing, as I've said before, it's not a huge issue if you can adapt. An external raise will look st and you'll limp as you can't bend your toes properly, heel only raise in boots works best IMO.

How much flexion have you got in your knee? If you've got less than about 110 degrees a short leg actually helps yikes

Feel free to PM me if you want to have a proper chat about your options, I've been like it thirty five years so I've got most of the bases covered.

I've probably mentioned it before, my Mrs didn't notice I've got a short leg until about three weeks after we met!

Dibble

Original Poster:

12,938 posts

241 months

Friday 20th December 2019
quotequote all
Cheers, WW. I’m going to wait until the New Year, then I might drop you a line. For now, I’m just going to enjoy Christmas and the New Year with my GF and The Idiot.

I don’t have to make a decision any time soon. My current plan is to strengthen up the muscles in my duff leg and be able to manage without crutches or a stick. I’ve got some time at the Police Treatment Centre in Harrogate, which will be a MASSIVE help with that.

If I do go for lengthening, it’s only going to be 15-20mm, rather than the 150mm or so I’ve already done, so it’ll be much quicker than the 18 months or so I had the frame on for previously (famous last words).

SpeckledJim

31,608 posts

254 months

Friday 20th December 2019
quotequote all
WinstonWolf said:
marksx said:
Regarding cycling, could you fit different length crank arms to your bike to compensate?
Yup, I've got a 165 one side and a 175 the other. It's OK but your shorter leg is generally weaker and the shorter crank arm takes more leverage. Different length cranks are fine on flattish rides but worse when climbing big hills. Takes me about 5 mins to swap to matched arms depending on the ride.
Invention Time!

A crank arm with a sliding, non-fixed pedal position, allowing you to adjust the effective length of the crank arm in a couple of seconds.

Perhaps adjusted by means of a threaded allen-headed screw from the end of the crank arm heading back towards the crank. Or, even faster, by a sprung ratchet type button, akin to a seat slider from a car.

Engineers: Go do your thing!

Edited by SpeckledJim on Friday 20th December 15:49

tvrolet

4,285 posts

283 months

Friday 20th December 2019
quotequote all
SpeckledJim said:
WinstonWolf said:
marksx said:
Regarding cycling, could you fit different length crank arms to your bike to compensate?
Yup, I've got a 165 one side and a 175 the other. It's OK but your shorter leg is generally weaker and the shorter crank arm takes more leverage. Different length cranks are fine on flattish rides but worse when climbing big hills. Takes me about 5 mins to swap to matched arms depending on the ride.
Invention Time!

A crank arm with a sliding, non-fixed pedal position, allowing you to adjust the effective length of the crank arm in a couple of seconds.

Perhaps adjusted by means of a threaded allen-headed screw from the end of the crank arm heading back towards the crank. Or, even faster, by a sprung ratchet type button, akin to a seat slider from a car.

Engineers: Go do your thing!

Edited by SpeckledJim on Friday 20th December 15:49
Better invention time - instead of different length cranks make them the same, but power them by sort of pistons in cylinders, y'know, like a motor in a cycle kind of thing. It could be a 'motor-cycle'.