Epiphysiodesis Procedure

On Thursday morning Mary had a "distal femoral epiphysiodesis using the phemister technique" aka a procedure to stop the growth in her growth plate in her longer leg in hopes to allow her shorter leg to grow and catch up to minimize her leg length discrepancy. The current discrepancy is approximately 3 cm.

This was procedure was number 7 for her fibular hemimelia. The first 5 were all associated with the external fixator in 2012 at age 9, then at age 11, she had an 8 plate put in her left knee and work on her left foot to help straighten it out. Mary is now almost 13.

• We had the first surgery time at 7:30, 
• Mary was more nervous for this procedure than I anticipated (older and wiser I guess),
• Dr. Scott's portion was only 37 minutes and we were called to recovery right before 9:00. 
• Other than shaking from the anesthesia initially (reminded me of me after by my deliveries of the girls), 
• recovery was fast and we headed home at 10. 

• We bought a machine that allows cold water to constantly "ice" the area for the first 48 hours (you do check the skin periodically and there shouldn't be direct contact with the skin). Insurance didn't cover it but we assume she will have more procedures, plus her parents aren't getting any younger and anyone can use it. We think it helped recovery a lot.

Mary has a strong pain tolerance. Although they prescribed a stronger pain med because the procure involves bone pain she only took over the counter ibuprofen at home. It is always nerve wracking going into the first night after a procedure because of concerns of pain management but Mary slept all night. Her first real discomfort after the procedure wasn't until 5:45 the following morning. Even then she said it was sore not painful. 

She really wanted to go to school the next day but the hardest part of the procedure has been using crutches. Her shorter, weaker left leg has to support her body since the procedure was on her stronger, longer right leg. She was unsteady as a result. 

She is very mature about the medical stuff and she realized it's better not to push too hard too fast so she can have a shorter recovery in the long run. If she went to school she also couldn't use the ice machine that seemed to be helping so much. 

It is day 3 and Mary hasn't had any medicine, she has iced a little bit and even practiced walking without crutches. 

So this procedure has proven to be "easy" as the medical world says it is. Medical easy isn't always easy in reality :-)

The procedure is a gamble because there isn't anything to precisely determine the best timing. You don't want to do it too early so that the short leg turns out to be longer than the longer leg that had the growth stopped, and doing it too late means its kind of wasted because the shorter leg doesn't get to catch up very much. Dr. Scott says it appears we have gotten pretty lucky, the growth plate looked like it still has some growth in it but not a ton. We have to wait and see the true success in 18-24 months when she should reach her adult height. She is almost 5'1".