Limb Lengthening Forum
Limb Lengthening Surgery => Limb Lengthening Discussions => Topic started by: texasbruce on February 08, 2016, 09:12:07 PM
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I am not sure about the two terms...
Does bilateral mean two osteotomies in one segment, or both femurs are done at the same time, or femur and tibia on one side are done at the same time?
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Ok nvm it is both femurs or both tibias
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This reminds me of my doubt of 1-stage procedure vs 2-stage procedure. I want to do tibia lengthening but I really don't want to live my life with a shorter leg, even if it is for a few months. It doesn't make sense to me to go through OR twice for the same thing.
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This reminds me of my doubt of 1-stage procedure vs 2-stage procedure. I want to do tibia lengthening but I really don't want to live my life with a shorter leg, even if it is for a few months. It doesn't make sense to me to go through OR twice for the same thing.
That's one big advantage of doing the legs both at once. If you do both legs with a set goal of 6 cm for example, and half way through you decide you can't take it anymore and want to stop, then you can stop lengthening and have your frames removed. With a two stage procedure, even if you revise your goal and want to stop shorter, you have to go for a second round no matter what.
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This reminds me of my doubt of 1-stage procedure vs 2-stage procedure. I want to do tibia lengthening but I really don't want to live my life with a shorter leg, even if it is for a few months. It doesn't make sense to me to go through OR twice for the same thing.
Well it makes sense if it is more life threatening due to fat embolism...
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Surprising I wasn't able to find more discussion on this.
It seems most CLL doctors prefer doing bilateral over unilateral too (at least the ones I've e-mailed). However, members like Key (http://www.limblengtheningforum.com/index.php?topic=5065.0) decided to do it unilaterally so they could remain working. Being able to go to the bathroom alone and do things more independently from early on seem like added bonuses. Pain and sleep may be more manageable too. I don't know; I'm not a LL vet. There's also the fact that the odds of embolism are smaller the less bones you break. But at the end of the day, it's still going through the same grueling process in two separate, distant occasions. That seems to be the deal breaker for most people.
Does anyone here feel any way about this, one way or another?
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Surprising I wasn't able to find more discussion on this.
It seems most CLL doctors prefer doing bilateral over unilateral too (at least the ones I've e-mailed). However, members like Key (http://www.limblengtheningforum.com/index.php?topic=5065.0) decided to do it unilaterally so they could remain working. Being able to go to the bathroom alone and do things more independently from early on seem like added bonuses. Pain and sleep may be more manageable too. I don't know; I'm not a LL vet. There's also the fact that the odds of embolism are smaller the less bones you break. But at the end of the day, it's still going through the same grueling process in two separate, distant occasions. That seems to be the deal breaker for most people.
Does anyone here feel any way about this, one way or another?
lowering the chances of fat embolism by a lot with two surgeries is very important.
I have done a lot of research and would never do bilateral internals. i am most likely going to do external tibias, but if I were to do internals... it would be unilateral surgeries.
hundreds of thousands of people get unilateral internal surgeries for leg length discrepancies or bilateral external tibia surgeries for deformity correction. almost none of these pts get fat embolism
how many cosmetic leg lengthenings does paley do a year? very far off from the sheer # of long bone orthopedic surgeries done for deformity complications or ll discrepancies. Still, the TOP cosmetic ll surgeon in the world and he himself, has had to deal with 4 fat embolism syndromes while doing cosmetic bilateral internal lengthening. the risk is there and so is the potential of death. I would rather go through the surgery process twice than deal with a potential fatal complication.
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After Stryde, the only reason to do unilateral is to minimize the chances of fat embolism.
However, still you can do both legs with about 1 month difference and not wait months to almost finish consolidation on the first leg to operate the second because that will lead to terrible time loss and a stupid huge discrepancy that must be covered with elevator shoes and bs like these.
For me, taking the small risk to do bilateral is more preferable than losing time and havimg discrepancy.
With Stryde you will be fully weight bearing so staying in wheelchair or walkers for months will be a distant past.
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After Stryde, the only reason to do unilateral is to minimize the chances of fat embolism.
However, still you can do both legs with about 1 month difference and not wait months to almost finish consolidation on the first leg to operate the second because that will lead to terrible time loss and a stupid huge discrepancy that must be covered with elevator shoes and bs like these.
For me, taking the small risk to do bilateral is more preferable than losing time and havimg discrepancy.
With Stryde you will be fully weight bearing so staying in wheelchair or walkers for months will be a distant past.
What about unilateral for tibias?
Even if you separate the surgeries by just one month, as you've said. Not worth it?
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What about unilateral for tibias?
Even if you separate the surgeries by just one month, as you've said. Not worth it?
for tibias the risk of fat embolism is much lower. Even dr. paley has stated this.
however, I would still do unilateral tibias one month apart to lower the risk of fat embolism by 50%.
Although tibias are much safer when it comes to fat embolism, internal tibias may lead to permanent knee pain. Therefore, most people pursue internal femurs over internal tibias.