Limb Lengthening Forum

Limb Lengthening Surgery => Limb Lengthening Discussions => Topic started by: Hobbit on May 23, 2022, 04:02:36 AM

Title: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: Hobbit on May 23, 2022, 04:02:36 AM
I’m about 5’8 and really want to get to 6’1. I did a 13cm mockup and I looked pretty good since my torso and wingspan are relatively longer than my legs. However, if I lengthen 8cm on my femurs and a year later lengthen 5cm in my tibia, will there be a drastic loss of athleticism? The main sports I do is lifting (upper body only), boxing and bjj so I won’t need to run a lot but i’m afraid I won’t be able to walk normally. Has anyone here done quadrilateral lengthening of 10cm+? If so, please share you experience.
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: JJ299 on May 23, 2022, 04:11:34 AM
Try looking at Japanese twitter bloggers. Lot of them do quads and their diaries are fairly detailed/frequent with pictures.
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: tallmen on May 23, 2022, 05:30:37 AM
I’m about 5’8 and really want to get to 6’1. I did a 13cm mockup and I looked pretty good since my torso and wingspan are relatively longer than my legs. However, if I lengthen 8cm on my femurs and a year later lengthen 5cm in my tibia, will there be a drastic loss of athleticism? The main sports I do is lifting (upper body only), boxing and bjj so I won’t need to run a lot but i’m afraid I won’t be able to walk normally. Has anyone here done quadrilateral lengthening of 10cm+? If so, please share you experience.

It's not practical. Tight hamstrings and quads will already put a lot of pressure on your knees.
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: Hobbit on May 23, 2022, 06:18:03 AM
Would you mind linking some of their twitters?
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: Hobbit on May 23, 2022, 06:18:34 AM
What if I gain a fair amount of flexibility before the surgery?
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: tpe2018 on May 23, 2022, 07:01:35 AM
Try looking at Japanese twitter bloggers. Lot of them do quads and their diaries are fairly detailed/frequent with pictures.

Where can I find it?
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: tallmen on May 23, 2022, 07:51:02 AM
What if I gain a fair amount of flexibility before the surgery?

All your flexibility will go to shiitt. IT band cut will swell up your side and you'll be on bed rest and with distraction hamstrings and quads will get real stiff and it's hard to do physio with all that pain. It's fking hard it's no joke. 1st do 1 segment and then you'll realize.
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: randy on May 23, 2022, 09:01:45 AM
All your flexibility will go to shiitt. IT band cut will swell up your side and you'll be on bed rest and with distraction hamstrings and quads will get real stiff and it's hard to do physio with all that pain. It's fking hard it's no joke. 1st do 1 segment and then you'll realize.

how difficult is it to work on the computer?
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: JJ299 on May 23, 2022, 09:03:25 AM
Where can I find it?
Would you mind linking some of their twitters?

pm'd
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: randy on May 23, 2022, 09:44:31 AM
pm'd
I am also interested please
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: Hobbit on May 23, 2022, 11:16:37 AM
Have you done the surgery?
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: motoboarder on May 25, 2022, 04:10:26 AM
how difficult is it to work on the computer?

For the first 2 months I could not focus on any computer cognitive task for more than 30min. Because the constant stretch in your muscles keeps your brain busy handling it.
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: motoboarder on May 25, 2022, 04:14:58 AM
Generally I don't recommend lengthening 5in. If you really want beyond 4in, don't do qualilateral because too likely you won't make it.
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: Hobbit on May 25, 2022, 04:42:07 AM
I said i’m planning to do femur and then tibia a year later. I’m not doing simultaneous quadrilateral lengthening.
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: motoboarder on May 25, 2022, 05:36:50 AM
I said i’m planning to do femur and then tibia a year later. I’m not doing simultaneous quadrilateral lengthening.

ahh.. ok. good luck :)
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: randy on May 25, 2022, 08:36:56 AM
ahh.. ok. good luck :)

Is it better to do 8cm in femurs or 4.5cm in femurs and 3.5cm in tibias simultaneously? I am asking purely medically and not anything else. Is it easier to stretch each bone segment for a short length (BUT simultanesouly) or stretch just the femur for 7-8cm?
Is simulataneous quad known to be "safe" as per research? Because Ilizarov showed us that it is ok to lengthen 1mm per day. But if we lengthen 1mm of each segment of the same leg 1mm per day then it is 2mm per day, isn't it?

And Thank you motoboarder for sharing your experience with us.
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: motoboarder on May 26, 2022, 04:42:15 AM
Is it better to do 8cm in femurs or 4.5cm in femurs and 3.5cm in tibias simultaneously? I am asking purely medically and not anything else. Is it easier to stretch each bone segment for a short length (BUT simultanesouly) or stretch just the femur for 7-8cm?
Is simulataneous quad known to be "safe" as per research? Because Ilizarov showed us that it is ok to lengthen 1mm per day. But if we lengthen 1mm of each segment of the same leg 1mm per day then it is 2mm per day, isn't it?

And Thank you motoboarder for sharing your experience with us.

IMO it's better to do 4.5cm femurs, 3.5cm tibias simul than whole 8cm femur. However if doing just 1 segment, I'd never exceed 4cm tibia or 6cm femur. I personally concluded these numbers from collective research from patient experiences/advices from this forum, cyborg4life blogs and few other medical articles related to LL.

Stretching for simul quad requires more effort as there're more exercises to cover all muscle groups. However to your question, in general yeah, I think distributing the "stress workload" (including stretching) to 2 segments is easier than asking just the femurs to achieve the whole 8cm.

"Is simul quad safe" - I think so. I survived, about >1mo into consolidation now. Flexibility still good until the end, so that the strictest PT at Paley's asked me "any reason you do NOT want to continue lengthening?". I was back to work the day I stopped lengthening, 40h/week software engineering i.e. cognitive function is as fine as before lengthening. I feel stable walking (actual alter steps) using walker, no duck ass. I'm not allowed standing/walking unaided yet so can't comment on that at this point. My thought.. to assess "safe", you have to be responsible with your own lengthening process: be disciplined with stretching/exercise, maintain healthy lifestyle/environment, stay relaxed, eat well, etc and most importantly, listen to your body. I.e. never rush getting more mm/day.

If you do simul quad, the medical standard of lengthening is .75mm/day femurs, .5mm/tibia, giving you 1.25mm/day of height gain. Some patients slow down a bit toward the end if they get tight. It should be unethical to lengthen faster than this.
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: Hobbit on May 26, 2022, 06:02:51 AM
What do you think of lengthening 7.5 in femur and 4.5 in tibia? Because if i’m 171cm, those lengths will make me 183cm(6ft) which is a great height.
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: motoboarder on May 26, 2022, 09:45:42 PM
What do you think of lengthening 7.5 in femur and 4.5 in tibia? Because if i’m 171cm, those lengths will make me 183cm(6ft) which is a great height.

I think it's quite a stretch on your body. A height gain should be practical to your biological body i.e. how much it can tolerate. Aiming for a fixed target too far is superficial IMO.

If this number is really important to you, do femur surgery first and tibia a year later, like someone here suggested. Get 3 month pre-surgery stretch (aim your goal to be a dancer!), work hard in each stage and listen to your body. Still I think don't fixate your mind on any number. Because should you not hit it, your mood would be down, impacting recovery. In other words, work hard but take it easy.
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: Hobbit on May 27, 2022, 05:52:25 AM
Ok thx for the advice.
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: Hobbit on May 27, 2022, 08:17:04 AM
Did you do femur and tibia with precise?
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: Hobbit on May 27, 2022, 10:12:15 AM
I’m not planning to do simultaneous. I want it to be atleast 1 year apart
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: motoboarder on May 27, 2022, 04:52:00 PM
Did you do femur and tibia with precise?

Yeah internal rod. I believe it's precice 2.2.
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: Hobbit on May 27, 2022, 05:23:42 PM
Were you flexible before your lengthening? Did you do any stretches before surgery?
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: motoboarder on May 28, 2022, 02:45:25 AM
Were you flexible before your lengthening? Did you do any stretches before surgery?

I was not naturally flexible. Yep, before surgery date, I stretched for 3 months, 45-60m every day. Check the 1st few posts of my diary, I had link to the exact exercises that I followed. I also explained how far you need to push to become crazily flexible compared to a normal person.
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: Hobbit on May 28, 2022, 03:59:44 AM
Since you were quite flexible leading up to the surgery, why didn’t you lengthen upto 8cm in the femurs and 5 cm in the tibia?
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: motoboarder on May 28, 2022, 06:54:26 AM
A number of reasons: I don't have big torso nor long arms, proportion would look weird pass 10cm; satisfied with this new height and it was my goal (achieved); <=10cm (for simul quadrilateral) was spec in the medical guideline given by Paley's; most importantly healthier recovery & life post LL. Even with this arguably moderate amount, I still had complication: a small area in front of my right tibia has alter sensation. The numbness started to happen at about 2week left of lengthening. This is usually a sign of later nerve pain/damage. If I continued further, very likely I'd have had it.
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: Hobbit on May 28, 2022, 04:30:51 PM
In your opinion, do you think lengthening 8cm on the femurs is a good idea?
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: TranslatingWithWriting on May 28, 2022, 06:13:46 PM
Many patients did 10cm+ lengthening on this forum and the most difficult part for you to undergo may be the 8cm femurs part. This will be very painful and time-consuming.
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: motoboarder on May 28, 2022, 08:25:00 PM
In your opinion, do you think lengthening 8cm on the femurs is a good idea?

Strong no IMO. If I did femur alone, I'd be comfortable with <=6cm, 6.5 if I stretch my comfort zone. Thigh muscles connect between your butt, back, hips, knee, all over the place. 8cm would pull too much and too likely will cause some chronic pains. Now look at the additional height gain, if you stand next to a guy 2cm taller than you, it doesn't look much different. The taller you are/were, the less noticeable.
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: motoboarder on May 28, 2022, 08:30:14 PM
I talked to some patients pushing through 8cm. In their words "the last few cm is the hardest, you just wanna quit" - my comment, well, if you're in this mindset, you're torturing your body. Why would you do that?.. My body never had this mindset during lengthening. So really, a good rule of thumb is to observe and listen to yourself, how you feel, during lengthening.
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: Hobbit on May 29, 2022, 04:53:23 AM
Were they able to recover and walk normally after lengthening the full 8cm on their femurs?
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: AimHigh on May 29, 2022, 08:53:55 AM
Hi, I am at 1.3 cm Precice CLL on RFem (did 5.4 cm on same femur 5 years ago) - also experiencing ~ 10x 10 cm numb/tingling patch on Anterior/Lateral mid tibia, and also strong tearing/burning sensation behind knee (medial) - annoying !
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: Hobbit on May 29, 2022, 09:29:47 AM
What do you think of lengthening the tibias alone upto 5cm?
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: motoboarder on May 29, 2022, 07:10:32 PM
Were they able to recover and walk normally after lengthening the full 8cm on their femurs?

Never met anyone post LL so I can't tell you. I think walking normally is probably possible. It's the long term discomfort which you have to live with if lengthening too much.
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: JamesBrown on June 30, 2022, 03:37:39 AM
I talked to some patients pushing through 8cm. In their words "the last few cm is the hardest, you just wanna quit" - my comment, well, if you're in this mindset, you're torturing your body. Why would you do that?.. My body never had this mindset during lengthening. So really, a good rule of thumb is to observe and listen to yourself, how you feel, during lengthening.

You pay for the same amount for 6cm increase or 8cm increase, may as well get the maximum amount. The pain is only temporary, but the increase in height is forever. I would push it no matter what.
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: motoboarder on June 30, 2022, 04:45:40 AM
You pay for the same amount for 6cm increase or 8cm increase, may as well get the maximum amount. The pain is only temporary, but the increase in height is forever. I would push it no matter what.

It's none of my concern when it comes to your personal choice. But if you intend to give others advice, IMHO, please don't. Go through the process yourself first, see how it'd work out. Who knows maybe you're flexible enough to lengthen the maximum. However, a majority of people are not. Statistics is your answer my friend, not theoretical confidence.
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: JamesBrown on June 30, 2022, 06:32:24 AM
It's none of my concern when it comes to your personal choice. But if you intend to give others advice, IMHO, please don't. Go through the process yourself first, see how it'd work out. Who knows maybe you're flexible enough to lengthen the maximum. However, a majority of people are not. Statistics is your answer my friend, not theoretical confidence.

You make a good point, noted.
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: Flokii on July 07, 2022, 03:19:26 PM
Man I haven't had surgery yet but I am agree with you in some point. Ofcourse there can be dilemmas during any recovery process but to have a focused mind is really helpful as far as I observe too. To listen the body's needs is a must in anytime also it should be so important in this process as well.



I talked to some patients pushing through 8cm. In their words "the last few cm is the hardest, you just wanna quit" - my comment, well, if you're in this mindset, you're torturing your body. Why would you do that?.. My body never had this mindset during lengthening. So really, a good rule of thumb is to observe and listen to yourself, how you feel, during lengthening.
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: Wayne75525 on November 04, 2022, 02:48:53 PM
Hi can you pm me the tweets as well
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: tallmen on November 05, 2022, 07:44:24 AM
Strong no IMO. If I did femur alone, I'd be comfortable with <=6cm, 6.5 if I stretch my comfort zone. Thigh muscles connect between your butt, back, hips, knee, all over the place. 8cm would pull too much and too likely will cause some chronic pains. Now look at the additional height gain, if you stand next to a guy 2cm taller than you, it doesn't look much different. The taller you are/were, the less noticeable.

BS logic. There's no hard limit of 6cm and it's very individual some people can tolerate 8cm very well others can not. It's more like 20% of your original length than 6cm.
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: informationispower on November 05, 2022, 10:18:27 AM
BS logic. There's no hard limit of 6cm and it's very individual some people can tolerate 8cm very well others can not. It's more like 20% of your original length than 6cm.
From talking to docs and reading diaries with reputable surgeons, it seems like everyone recovers almost 100% by doing max of 5-6cm on femurs. Its above that when recovery seems to get exponancially difficult
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: motoboarder on November 06, 2022, 06:12:38 AM
BS logic. There's no hard limit of 6cm and it's very individual some people can tolerate 8cm very well others can not. It's more like 20% of your original length than 6cm.

BS reply. Where in my answer did I say "hard limit". And do you understand what "IMO" stand for?
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: motoboarder on November 06, 2022, 06:22:02 AM
From talking to docs and reading diaries with reputable surgeons, it seems like everyone recovers almost 100% by doing max of 5-6cm on femurs. Its above that when recovery seems to get exponancially difficult

Certified this from my hands-on experience. It's been 6mo into consolidation and almost 4mo since I was allowed to walk unaided now. I've been enjoying so much of life. I took several domestic flights and have been walking long distances (e.g. 2-4h consistently around a shopping mall). And it will only get even better from here.
Title: Re: Quadrilateral Lengthening 8cm femur + 5 cm tibia outcomes?
Post by: tallmen on November 06, 2022, 06:49:54 AM
Certified this from my hands-on experience. It's been 6mo into consolidation and almost 4mo since I was allowed to walk unaided now. I've been enjoying so much of life. I took several domestic flights and have been walking long distances (e.g. 2-4h consistently around a shopping mall). And it will only get even better from here.

I also did 6cm femurs and doing fine (running, hiking etc.) but prob will rebreak and go for full 8cm.