Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[tacoma94]

Hi,

I am a 168cm male, with a measured length of around 37.5cm in my Tibias. I am looking at using externals/LATN. I wanted to ask about the recovery time and risks for this procedure. As of now, I am planning to go with a renowned doctor like Donghoon Lee and Paley.

By my calculations, I am lengthening about 10.66 - 12% of my bone length (willing to stop before that for safety too). I am placing a hard limit of 4.5cm, will probably go below that. I have read the forums on LON, LATN and pure externals, and some diaries. I have about 7 months of free time after college, and I wanted to do an initial assessment to see what stage of recovery I can reach in that time, with the different methods, and what risks I can expect.

I have often heard that pure externals are safest with Tibias, although they take the longest. I have heard that 1.5 - 2 months per cm is average for recovery for Tibias external. This gives me 6 - 8 month with 4cm, a conservative length ~10%.
1. May I ask, what exactly does 6-8 months mean? Does this mean time to walking (not running, just slow walking).
2. What exactly is the bottleneck for recovery here? Is it muscle strength, or bone consolidation (meaning if I step too hard, I will snap my tibia).
3. How true is this 6-8 month? I have seen diaries go up to 10 months, 11 months. And these were fit young men.
4. Does the fact that I am working with a good doctor lower the risk of complications, or does it just mean they will be able to fix my complications when they come?

Furthermore, I want to ask about LATN. As I understand, this is to reduce time in fixators (by 1/3). It involves taking out the fixator, putting in a nail, which involves parting the patella tendon, inducing the major risk of nerve damage. Presumably, the nail is inert (not magnetic for lengthening), allows weight bearing (for faster walking/recovery). I have some questions about the nail.
5. How fast to crutch/walk with the nail? Say, from starting surgery, and with a conservative surgery + lengthening time of 60 days (maybe 0.75mm some days)
6. I did externals, tibia to avoid fat embolism, pulmonary embolism and deep vein thrombosis risks. But isn't LATN just nailing the bone again? Do these risks arise, and are they reduced as opposed to say, internal tibias/femurs with stryde?
7. What is the severity of the permanent knee pain with a good doctor? Why is it permanent? Why can't therapy, or even 10 years, cause the pain to go away?

Lastly,
8. Dr lee states that 30-40% of the lengthening recovery is up to the patient. How much of a difference beyond just doing basic physical therapy can be made to the recovery time?

Very sorry for the long post, but I was hoping this post could answer some questions about external tibs, a common option, esp among different methods, that I haven't been able to find answers to even after reading the forums.

[Sanity]

4.5cm could be around 5-6 months. and im not sure paley still does externals.
and for LATN im not sure if they do the reaming or not. I think they just put in the nail. p.s there is always slight risk of something going wrong ofcoarse.

[tacoma94]

Are you referring 5-6 months to crutches? And is this externals only or LATN

[TemakiSushi]

Paley doesn’t do external LATN nor LON for cosmetics
Donghoon mainly does LON instead of LATN now because with his method of LON, bone formation is faster than old methods
Unless there are quite severe deformities, it’s better to do LON than LATN
But if you have very tight schedule then better to do with Stryde than any external methods