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[LG1816]

Hi, Couple of questions about the pure external method.

1. How long do you typically have to wear the frames for for 5cm?

2. At the point the frames have been removed, do you then go through a consolidation process as you would with LON/LATN?

3. Are the frames fully weight bareing?

4. What are risk of fat or pulmonary embolism compared with internals and LON/LATN?

Thanks!

[saltedchocolate]

1. For about 5 cm, it will take about 2.5-3 months for lengthening and then 2 months per cm for consolidation. So about 10-12 months. (Sometimes more)

2. No, you get the frames removed once you’re completely consolidated and ready for full weight bearing

3. yes but its better to use assistance for support since the frames are bulky.

4. There is always a risk of pulmonary embolism in any method of LL but the risk of infection is highly reduced when compared with LON.

+ if you’re planning to do externals on tibias my suggestion is that you stretch a lot before surgery that way it’ll be easier for your achilles to not tighten to a level thats not fixable with physiotherapy.
Keep stretching your achilles using a band or something and pull it towards you as much as you can and also stand a lot during lengthening to combat ballerina!
Slow and steady wins the race!

Hope this helps

[DanishViking]

https://pubmed.ncbi.nlm.nih.gov/26398436/

[LG1816]

Thanks a lot, that clears it up!

The main reason I was considering pure externals was because of the knee pain associated with LON. Have you experienced anything like this?

[LG1816]

Yeah, this is definitely my main concern with tibial lengthening, though then I'm also worried about the higher incidence with embolism with femurs, and I think tibia lengthening would look a lot more aesthetic as well; I'd worry that if I lengthened say, 6 cm with femurs, my proportions would look a bit weird. Thanks

[kamaruusman]

Tibia extension is more aesthetic. Also, the femur is curved, which means you can't get 100% of the amount you lengthening. It's safer to go lon instead of latn. There will be no risk of improper union of your bone. Knee pain is not proven and no operation is performed on the knees. The nail is placed below the knee. Besides, living with fixators for 12 months would be really torture.

Safest is pure external.

[Body Builder]

Hi, Couple of questions about the pure external method.

1. How long do you typically have to wear the frames for for 5cm?

2. At the point the frames have been removed, do you then go through a consolidation process as you would with LON/LATN?

3. Are the frames fully weight bareing?

4. What are risk of fat or pulmonary embolism compared with internals and LON/LATN?

Thanks!

For 5cm you would wear external fixators for less than 8 months.
Its not a good decision to do Lon/Latn for these amounts because it is a much more invasive procedure and you also need another major surgery some years after to remove nails.
If you want only 5cm, be patient and go for full externals. The difference is less tham 6 months as for 2+ months you will have fixators to lengthen in both cases.
For me pure externals for tibias is by far the best solution. Especially when you want to lengthen relatively small amounts.

[EndGame]

For 5cm you would wear external fixators for less than 8 months.
Its not a good decision to do Lon/Latn for these amounts because it is a much more invasive procedure and you also need another major surgery some years after to remove nails.
If you want only 5cm, be patient and go for full externals. The difference is less tham 6 months as for 2+ months you will have fixators to lengthen in both cases.
For me pure externals for tibias is by far the best solution. Especially when you want to lengthen relatively small amounts.
[/tibias and figured
Wait, what's the general rule on time from surgery to consulted and weight bearing per cm in externals? I thought I'd heard 1.5-2 months per cm? And isn't there a month in a cast after frame removal? Less than 8, so you figure only like what 7 months for 5cm external tibias? Internals would be like 5-6 months for 5cm?

[LG1816]

Thanks for the reply.

For 5cm you would wear external fixators for less than 8 months.

How long do you think for 6cm? I'm just over 5'8.5, and from what I've read, 6cm tibias is possible if you're a bit taller to begin with. So I was considering that about.

Its not a good decision to do Lon/Latn for these amounts because it is a much more invasive procedure

Other than the second surgery to remove the nails, why else do you think LON/LATN is a bad option? Are the risks of fat/pulmonary embolism higher? Or is it the stuff about the risk of knee pain?