Ouch (possible NSFW pictures of my rear to follow)
Discussion
I get where you're coming from with wanting to leave the metalwork where it is, the nail has been inside my femur for over 30 years.
After it had been in there for a couple of years I enquired about having it removed but the surgeons didn't want to remove it for a few reasons, the risk of another anesthetic, chance of infection and it's fairly major surgery too.
It's unfixed anyway which is probably why it hasn't caused me any problems, well apart from airport security and their 'wands'
After it had been in there for a couple of years I enquired about having it removed but the surgeons didn't want to remove it for a few reasons, the risk of another anesthetic, chance of infection and it's fairly major surgery too.
It's unfixed anyway which is probably why it hasn't caused me any problems, well apart from airport security and their 'wands'
Dibble said:
WinstonWolf said:
Built up shoes are s
t, I had one that looked like a club foot shoe...
Inserts are infinitely better IMO, they allow your foot to work over a much wider angle and you can walk with a more natural gait.
It's certainly worth giving one a go if you get a chance.
Good luck!
I’ve got an orthotic insert of 12mm for each shoe and then the sole is built up by 16mm. The boot definitely works better than the trainer, as I don’t get my heel lifting out the same way. They’re ok, but not great. While I’ve options to try and improve length (oo-er, Matron), I’m going to go as far as I can with that. I’ve the additional issues with knee function and alignment at the top of my femur to try and get sorted and hopefully, the surgery will improve those areas as well. It’s a bit of a three for one deal and even minimal gains with knee function/bone alignment will be better, even if the length doesn’t change. t, I had one that looked like a club foot shoe...Inserts are infinitely better IMO, they allow your foot to work over a much wider angle and you can walk with a more natural gait.
It's certainly worth giving one a go if you get a chance.
Good luck!
The ankle can accommodate a lot of shortening, but you need to be able to roll your toes which a full length raise prevents. You're probably raising your hip and stalling briefly as your duff leg comes off the floor?
The surgery is obviously going to bring you benefit in the longer term but a heel only insert is worth trying in the short term. Your calf muscle will soon develop.
WinstonWolf said:
Dibble said:
WinstonWolf said:
Built up shoes are st, I had one that looked like a club foot shoe...
Inserts are infinitely better IMO, they allow your foot to work over a much wider angle and you can walk with a more natural gait.
It's certainly worth giving one a go if you get a chance.
Good luck!
I’ve got an orthotic insert of 12mm for each shoe and then the sole is built up by 16mm. The boot definitely works better than the trainer, as I don’t get my heel lifting out the same way. They’re ok, but not great. While I’ve options to try and improve length (oo-er, Matron), I’m going to go as far as I can with that. I’ve the additional issues with knee function and alignment at the top of my femur to try and get sorted and hopefully, the surgery will improve those areas as well. It’s a bit of a three for one deal and even minimal gains with knee function/bone alignment will be better, even if the length doesn’t change. t, I had one that looked like a club foot shoe...Inserts are infinitely better IMO, they allow your foot to work over a much wider angle and you can walk with a more natural gait.
It's certainly worth giving one a go if you get a chance.
Good luck!
The ankle can accommodate a lot of shortening, but you need to be able to roll your toes which a full length raise prevents. You're probably raising your hip and stalling briefly as your duff leg comes off the floor?
The surgery is obviously going to bring you benefit in the longer term but a heel only insert is worth trying in the short term. Your calf muscle will soon develop.
Dibble said:
I’m bloody starving already and it’s going to be another four and half hours until I can eat! I’ll be leaving home in a bit to get to the scan appointment. I can confirm that drinking loads of water does not “fill you up”. It just means I need a piss every five bloody minutes!
At least you're still around to experience the joys of getting older 
Dibble said:
I’m bloody starving already and it’s going to be another four and half hours until I can eat! I’ll be leaving home in a bit to get to the scan appointment. I can confirm that drinking loads of water does not “fill you up”. It just means I need a piss every five bloody minutes!
Tena pads for the journey?Good luck anyway!
The scan all went fine. Because it was at 4.30pm, the hospital was pretty quiet and they’ve got the one way system/masks/distancing all sorted out. I got checked in, weighed and measured (I’m still a fat knacker) and injected with the isotope. Then you just have to sit around fir an hour, so I had a snooze as they prefer you not to read etc.
Then i5 was int9 the scanner for about 40 minutes, so I took the opportunity for another snooze! I know some people don’t like being inside the machine, but they were only doing my bottom half, so I wasn’t all the way in anyway.
I won’t get the results until I next see the consultant towards the end of August. The images take a little while to process/stitch together and then they send them to the consultant for her to look at. She’ll also discuss them with a consultant from the imaging department.
I’m still not convinced about the Stryde nail. After all the faff so far with infections, I’m still not keen. I’ll just have to wait and see what the consultant says and talk through the results and options with her at my next appointment. I’m really happy with her and I really trust her as well. She doesn’t pull any punches or flower stuff up, she’s very straight talking, takes as much time as I need and explains stuff in a way I understand what she’s telling me.
Then i5 was int9 the scanner for about 40 minutes, so I took the opportunity for another snooze! I know some people don’t like being inside the machine, but they were only doing my bottom half, so I wasn’t all the way in anyway.
I won’t get the results until I next see the consultant towards the end of August. The images take a little while to process/stitch together and then they send them to the consultant for her to look at. She’ll also discuss them with a consultant from the imaging department.
I’m still not convinced about the Stryde nail. After all the faff so far with infections, I’m still not keen. I’ll just have to wait and see what the consultant says and talk through the results and options with her at my next appointment. I’m really happy with her and I really trust her as well. She doesn’t pull any punches or flower stuff up, she’s very straight talking, takes as much time as I need and explains stuff in a way I understand what she’s telling me.
Dibble said:
The scan all went fine. Because it was at 4.30pm, the hospital was pretty quiet and they’ve got the one way system/masks/distancing all sorted out. I got checked in, weighed and measured (I’m still a fat knacker) and injected with the isotope. Then you just have to sit around fir an hour, so I had a snooze as they prefer you not to read etc.
Then i5 was int9 the scanner for about 40 minutes, so I took the opportunity for another snooze! I know some people don’t like being inside the machine, but they were only doing my bottom half, so I wasn’t all the way in anyway.
I've only had to have an isotope scan once. I found it super weird being able to feel the warmth as it spreads through your body. The scan itself was fine. MRI's suck though, a really small opening, they are loud and the noises are not confidence-inspiring (luckily mine was just a foot injury).Then i5 was int9 the scanner for about 40 minutes, so I took the opportunity for another snooze! I know some people don’t like being inside the machine, but they were only doing my bottom half, so I wasn’t all the way in anyway.
2ndclasscitizen said:
I've only had to have an isotope scan once. I found it super weird being able to feel the warmth as it spreads through your body. The scan itself was fine. MRI's suck though, a really small opening, they are loud and the noises are not confidence-inspiring (luckily mine was just a foot injury).
I had a scan a few years ago, I say scan but it was multiple ones, 1 was about 90 seconds, 1 around 35 mins and various ones in between. I was completely inside the tube as well, not a great place if you are remotely claustrophobic ( i'm not thankfully). All i can say is i know how a 1 person German Techno Rock nightclub would feel like 
I had one a few years back, for what turned out to be a salivary duct stone. I don't recall it being loud at all, despite my head obviously being in the tube completely. Nice and warm from the marker, though. And doped up on IV painkillers, too. I also took the opportunity for a nap.
Alas, only a few minutes worth, 5 at most.
Alas, only a few minutes worth, 5 at most.
Had an MRI on my knee.
At the time I had not long ago had an operation for a total knee replacement so all the stories about MRI machines ripping out bits of metal were giving me a bit of anxiety.
Got there, they saw the scars, read the notes, and said "Ah, sorry sir, we can't put you in this MRI machine, you'll have to be booked into the special one" (that can cope with metal bits).
Seems that titanium isn't ferrous so isn't affected by MRIs, but any metal at all will completely mess up a normal MRI image so they have a special MRI machine for people with metal in them.
Normal MRI machines cost eeek, gawd knows how much the special one cost.
But thanks to the Nuffield in Oxford, they had one.
At the time I had not long ago had an operation for a total knee replacement so all the stories about MRI machines ripping out bits of metal were giving me a bit of anxiety.
Got there, they saw the scars, read the notes, and said "Ah, sorry sir, we can't put you in this MRI machine, you'll have to be booked into the special one" (that can cope with metal bits).
Seems that titanium isn't ferrous so isn't affected by MRIs, but any metal at all will completely mess up a normal MRI image so they have a special MRI machine for people with metal in them.
Normal MRI machines cost eeek, gawd knows how much the special one cost.
But thanks to the Nuffield in Oxford, they had one.
The show rolls on...
I had the follow up with the consultant yesterday. The good news is that my most recent PET CT scan is showing absolutely no signs of infection, at all. In this image, the picture on the left is my scan from about three weeks ago and the one on the right is just before they started the reconstruction surgery. The lighter colours show infection and as you can see from the image on the right, there’s a fair bit there. As they scrolled through the image layers on screen, there was a fair bit of red as well, which is the highest level present. There was nothing in the recent scan, so I’m as infection free as they can tell.
A bit more of the previous lurking gunk...
I went through the options again with the consultant (and the registrar there on rotation). I had about 90 minutes with them altogether as I had a big list of questions to ask them. I’d already decided that I was going to go for more femur lengthening as it seems sensible to not mess around with the as-yet unmessed around with leg. If I went for shortening of the good femur, I’d lose a lot of quadriceps function, at least initially, while gaining nothing in my right leg, which there are still issues with.
The issues at the moment are lack of knee bend range, some over rotation of my foot, the fact the femur is shorter and it’s not the right shape, causing my hip/knee/ankle to be out of alignment. The options for lengthening are the Stryde nail or another external frame and there are pros and cons for both. For me, the biggest risk with the Stryde nail is infection. Because it would be completely enclosed, any infection that did appear would take longer to show up, whereas with pins and a rail, it becomes obvious fairly quickly.
To insert a Stryde nail, they need a straight run to hammer it into - it goes inside the bone cavity itself. As you can see, there’s a definite bend at the top of my femur (as well as what looks like half a face of Jeebus, hidden in there!). It seems counterintuitive to me to remove the bone I’ve grown, to stick the Stryde nail in and risk an infection, which puts my whole femur (and potentially leg) at risk. Yes, they could start with that and see how it goes, but why faff about when there’s another, workable option? I’d also end up with a semi-permanent nail down my femur, even if the Stryde worked. My body doesn’t seem to be a huge fan of metal being attached internally.
If I go for another external rail, I know exactly what’s involved and what to look out for. The rail itself can be fixed lower than previously, so it won’t stick out from my leg quite so much, so will be marginally less awkward. They can straighten the head of my femur out and lose less bone doing so than if I go for the Stryde option. Yes, I’ll still have bits of metal in my bone, but the area/volume they take up will comparatively be much less. Straightening the femur will also improve my hip/knee ankle alignment, which in turn, should improve knee function. They’ll manipulate the knee joint while I’m in theatre to “reduce adhesions”, which is no fun for a couple of days afterwards, as it basically means ripping off any bits of muscle/ligament/tissue that has attached itself where it shouldn’t... they will also probably remove the last rogue pin that’s in my knee from the original surgery, which should also help, while at the same time, reduce an infection site.
Despite how all this reads so far, I’ve not made a final decision, but I’m definitely leaning towards more of the same with the external rail again. I don’t have to decide just yet as I’ve no date for the next surgeries to start, but I am on the list for pre-op assessment and the consultant says she wants me near the top of the list, as she knows how long it’s being going on for. Despite me being somewhat of a problem child, I’ve never once felt she isn’t totally invested in getting the absolute best result for me, however long it takes or how complicated it gets (which is completely at odds to the initial orthopaedic consultant, who seemed like he couldn’t wait to get rid of me).
TL;DR More of the same to straighten my bendy femur and make it longer so I’m balanced (for the first time in my life!)
I had the follow up with the consultant yesterday. The good news is that my most recent PET CT scan is showing absolutely no signs of infection, at all. In this image, the picture on the left is my scan from about three weeks ago and the one on the right is just before they started the reconstruction surgery. The lighter colours show infection and as you can see from the image on the right, there’s a fair bit there. As they scrolled through the image layers on screen, there was a fair bit of red as well, which is the highest level present. There was nothing in the recent scan, so I’m as infection free as they can tell.
A bit more of the previous lurking gunk...
I went through the options again with the consultant (and the registrar there on rotation). I had about 90 minutes with them altogether as I had a big list of questions to ask them. I’d already decided that I was going to go for more femur lengthening as it seems sensible to not mess around with the as-yet unmessed around with leg. If I went for shortening of the good femur, I’d lose a lot of quadriceps function, at least initially, while gaining nothing in my right leg, which there are still issues with.
The issues at the moment are lack of knee bend range, some over rotation of my foot, the fact the femur is shorter and it’s not the right shape, causing my hip/knee/ankle to be out of alignment. The options for lengthening are the Stryde nail or another external frame and there are pros and cons for both. For me, the biggest risk with the Stryde nail is infection. Because it would be completely enclosed, any infection that did appear would take longer to show up, whereas with pins and a rail, it becomes obvious fairly quickly.
To insert a Stryde nail, they need a straight run to hammer it into - it goes inside the bone cavity itself. As you can see, there’s a definite bend at the top of my femur (as well as what looks like half a face of Jeebus, hidden in there!). It seems counterintuitive to me to remove the bone I’ve grown, to stick the Stryde nail in and risk an infection, which puts my whole femur (and potentially leg) at risk. Yes, they could start with that and see how it goes, but why faff about when there’s another, workable option? I’d also end up with a semi-permanent nail down my femur, even if the Stryde worked. My body doesn’t seem to be a huge fan of metal being attached internally.
If I go for another external rail, I know exactly what’s involved and what to look out for. The rail itself can be fixed lower than previously, so it won’t stick out from my leg quite so much, so will be marginally less awkward. They can straighten the head of my femur out and lose less bone doing so than if I go for the Stryde option. Yes, I’ll still have bits of metal in my bone, but the area/volume they take up will comparatively be much less. Straightening the femur will also improve my hip/knee ankle alignment, which in turn, should improve knee function. They’ll manipulate the knee joint while I’m in theatre to “reduce adhesions”, which is no fun for a couple of days afterwards, as it basically means ripping off any bits of muscle/ligament/tissue that has attached itself where it shouldn’t... they will also probably remove the last rogue pin that’s in my knee from the original surgery, which should also help, while at the same time, reduce an infection site.
Despite how all this reads so far, I’ve not made a final decision, but I’m definitely leaning towards more of the same with the external rail again. I don’t have to decide just yet as I’ve no date for the next surgeries to start, but I am on the list for pre-op assessment and the consultant says she wants me near the top of the list, as she knows how long it’s being going on for. Despite me being somewhat of a problem child, I’ve never once felt she isn’t totally invested in getting the absolute best result for me, however long it takes or how complicated it gets (which is completely at odds to the initial orthopaedic consultant, who seemed like he couldn’t wait to get rid of me).
TL;DR More of the same to straighten my bendy femur and make it longer so I’m balanced (for the first time in my life!)
fwaggie said:
Had an MRI on my knee.
At the time I had not long ago had an operation for a total knee replacement so all the stories about MRI machines ripping out bits of metal were giving me a bit of anxiety.
Got there, they saw the scars, read the notes, and said "Ah, sorry sir, we can't put you in this MRI machine, you'll have to be booked into the special one" (that can cope with metal bits).
Seems that titanium isn't ferrous so isn't affected by MRIs, but any metal at all will completely mess up a normal MRI image so they have a special MRI machine for people with metal in them.
Normal MRI machines cost eeek, gawd knows how much the special one cost.
But thanks to the Nuffield in Oxford, they had one.
I’ve only just seen your email I’m afraid, while I was checking my junk (so to speak), so I’ll ping you a reply in a bit, but thanks for taking the time to wrote and I’m sorry if you thought I was being ignorant and ignoring you! I do try to reply to all the emails people have been kind enough to send me, as well as comments on here. They are all much appreciated. At the time I had not long ago had an operation for a total knee replacement so all the stories about MRI machines ripping out bits of metal were giving me a bit of anxiety.
Got there, they saw the scars, read the notes, and said "Ah, sorry sir, we can't put you in this MRI machine, you'll have to be booked into the special one" (that can cope with metal bits).
Seems that titanium isn't ferrous so isn't affected by MRIs, but any metal at all will completely mess up a normal MRI image so they have a special MRI machine for people with metal in them.
Normal MRI machines cost eeek, gawd knows how much the special one cost.
But thanks to the Nuffield in Oxford, they had one.
I didn’t have the special length adjusting nail in my femur but I did have a titanium rod through the middle of the bone from hip to knee. Just my experience but didn’t have any problems, fixed leg and was taken out a year later. Appreciate you have had problems with infections. However if you an external framework you have holes in your leg and wouldn’t that be a pathway for infection?
Esceptico said:
I didn’t have the special length adjusting nail in my femur but I did have a titanium rod through the middle of the bone from hip to knee. Just my experience but didn’t have any problems, fixed leg and was taken out a year later. Appreciate you have had problems with infections. However if you an external framework you have holes in your leg and wouldn’t that be a pathway for infection?
Cheers chaps.You would think the pins would be more an infection vector, as they go from the outside to the inside, but from what I’ve been told, our bodies are actually pretty good at sealing the holes. It’s actually quite difficult for an infection to track all the way down from the skin and there’s lots of defensive stuff in each layer, which prevents it happening (in most cases). The pin site care routine is pretty stringent as well, at least initially. Once the pin sites have scabbed over a bit, they’re pretty effective at sealing themselves. You can’t get them wet, so showering is tricky. If there is any infection internally, the pin sites give any gunge an easy route out and it’s easier to see earlier, rather than anything buried in there. It seems counterintuitive, but for me, as I’m prone to infection, I’m better having less metal in the bone itself, which is one of the benefits of the external rail and pins.
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