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Author Topic: LL Complications Stream with Dr. Paley  (Read 1499 times)

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cyborg4life

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LL Complications Stream with Dr. Paley
« on: October 19, 2022, 12:34:50 PM »

Hey everyone, I hope you’re doing well. I just wanted to drop by to let you know about a highly requested live stream that’s finally going to be happening. This Saturday 10-22 at 10am EDT we’ll be hosting Dr. Paley as he does a thorough overview on limb lengthening complications.

On the agenda will be the following…

-Overview of complications (fat & pulmonary emboli, contractures, delayed/non-union, premature consolidation, nerve compression, malalignment, IT
 band release, bone marrow after reaming, etc. including what they are, how likely and treatment modalities)

-Submitted patient cases with x-rays for review

-New STRYDE info? He’s actually on the development board after all - I’ll try on this one lol.

-LIVE Q&A - might be brief as he is leaving town the same day so it depends. But bring your best questions in case we have time.

Anyways here's the link if you want to check it out

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SpeedDialer

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Re: LL Complications Stream with Dr. Paley
« Reply #1 on: October 19, 2022, 02:09:45 PM »

Hey everyone, I hope you’re doing well. I just wanted to drop by to let you know about a highly requested live stream that’s finally going to be happening. This Saturday 10-22 at 10am EDT we’ll be hosting Dr. Paley as he does a thorough overview on limb lengthening complications.

On the agenda will be the following…

-Overview of complications (fat & pulmonary emboli, contractures, delayed/non-union, premature consolidation, nerve compression, malalignment, IT
 band release, bone marrow after reaming, etc. including what they are, how likely and treatment modalities)

-Submitted patient cases with x-rays for review

-New STRYDE info? He’s actually on the development board after all - I’ll try on this one lol.

-LIVE Q&A - might be brief as he is leaving town the same day so it depends. But bring your best questions in case we have time.

Anyways here's the link if you want to check it out



You're a gift to the community cyborg

Unfortunately I've been tired during femur LL and I misread the title as "LL Complications stream from Dr. Paley"

So I think a concern of late is Dr. Assayag might have mentioned that non union was happening at higher than expected rates for the old styrde nail compared to precise and I wondered if Dr. Paley had any thoughts on that or some possible explanations
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SpeedDialer

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Re: LL Complications Stream with Dr. Paley
« Reply #2 on: October 20, 2022, 05:28:13 PM »

The youtube video where Dr. Paley said the stretching before surgery only lasts 24 hours, could you please ask him to elaborate on that? How does it work? Ex: does he see that all the pre-surgery stretching range of motion gains are lost after 24 hours and they go back to how it was before they started stretching? Or something else?

Thank you
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lessthanavg8300

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Re: LL Complications Stream with Dr. Paley
« Reply #3 on: October 20, 2022, 08:13:18 PM »

Theres all sorts of complications that individually may be rare.  But curious what the overall odds of getting some kind of complication are when you add them all up.  Do the vast majority make it through without an issue?
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Gained 3.2CM on femurs for a final height of 5'8.5-5'8.75.

SpeedDialer

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Re: LL Complications Stream with Dr. Paley
« Reply #4 on: October 21, 2022, 10:12:42 PM »

Which complications are most closely associated with accidental, non-obvious (to the patient) mistakes made by patients?

So excluding things like "knew he did not stretch enough/lengthened too much against doctor's advice, got ballerina foot" -> something like this would be too obvious, I mean things that are more subtle
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Limbfan2020

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Re: LL Complications Stream with Dr. Paley
« Reply #5 on: October 23, 2022, 09:02:29 AM »

Probably the best interview on your channel! Thank you so much, Victor!

Who were the doctors he trashed?
- Dr. D. from Las Vegas
- Dr. G. from Athens
- Dr. S. from Dehli?

Who else?


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informationispower

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Re: LL Complications Stream with Dr. Paley
« Reply #6 on: October 23, 2022, 11:01:28 AM »

Probably the best interview on your channel! Thank you so much, Victor!

Who were the doctors he trashed?
- Dr. D. from Las Vegas
- Dr. G. from Athens
- Dr. S. from Dehli?

Who else?

At which points in the video did he mentioned other doctors?
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Limbfan2020

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Re: LL Complications Stream with Dr. Paley
« Reply #7 on: October 23, 2022, 03:57:35 PM »

At which points in the video did he mentioned other doctors?

To answer your question, i'd need to watch the 3h interview again! Basically he trashed almost every doctor execpt himself;)

It was a brilliant interview since he mentioned some details which are very important to consider during the surgery. He made it clear: LL is not like just drilling a hole into ur bone and inserting a metal stick.

Due to this interview, I really consider him as my future LL surgeon although i'd have plenty of choices here in Europe. Extraordinary doctor!
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SpeedDialer

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Re: LL Complications Stream with Dr. Paley
« Reply #8 on: October 23, 2022, 08:40:43 PM »

Probably the best interview on your channel! Thank you so much, Victor!

Who were the doctors he trashed?
- Dr. D. from Las Vegas
- Dr. G. from Athens
- Dr. S. from Dehli?

Who else?

What were his specific criticisms of Dr. G (ex: time stamp, topics)? Gonna meet with Dr. Giotikas this week, not sure if I should ask about anything

Also thank you so much cyborg for doing this interview, the knowledge per minute (KPM) was high as the Invest Answers youtube channel guy would probably say
« Last Edit: October 23, 2022, 10:26:27 PM by SpeedDialer »
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Vogel

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Re: LL Complications Stream with Dr. Paley
« Reply #9 on: October 23, 2022, 10:49:14 PM »

What were his specific criticisms of Dr. G (ex: time stamp, topics)? Gonna meet with Dr. Giotikas this week, not sure if I should ask about anything

Also thank you so much cyborg for doing this interview, the knowledge per minute (KPM) was high as the Invest Answers youtube channel guy would probably say


He didn’t say anything specific about Dr. G. He only said that people go to Greece, India, Egypt… etc. And come back to him with complications.

The only docs that he trashed are the one from New Delhi and Dr. D. He also said that besides him their are only a handful of surgeons that are as qualified as him. However, he didn't mention their names.
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SpeedDialer

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Re: LL Complications Stream with Dr. Paley
« Reply #10 on: October 24, 2022, 12:43:19 AM »


He didn’t say anything specific about Dr. G. He only said that people go to Greece, India, Egypt… etc. And come back to him with complications.

The only docs that he trashed are the one from New Delhi and Dr. D. He also said that besides him their are only a handful of surgeons that are as qualified as him. However, he didn't mention their names.

Yeah hm... I am doing gnail femurs with Dr. G rn and am planning on doing internal tibias with him later and am a bit worried now

Not sure where to start

I guess I could ask Dr. G about the two ended tibia/fibula fixation or w/e I did not quite understand what Dr. Paley was describing

What would you guys ask him?
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liltunechi

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Re: LL Complications Stream with Dr. Paley
« Reply #11 on: October 24, 2022, 10:23:33 AM »


He didn’t say anything specific about Dr. G. He only said that people go to Greece, India, Egypt… etc. And come back to him with complications.

The only docs that he trashed are the one from New Delhi and Dr. D. He also said that besides him their are only a handful of surgeons that are as qualified as him. However, he didn't mention their names.

Has he ever spoke about Dr Mangal Parihar?
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RealLostSoul

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Re: LL Complications Stream with Dr. Paley
« Reply #12 on: October 24, 2022, 12:32:02 PM »

Yeah hm... I am doing gnail femurs with Dr. G rn and am planning on doing internal tibias with him later and am a bit worried now

Not sure where to start

I guess I could ask Dr. G about the two ended tibia/fibula fixation or w/e I did not quite understand what Dr. Paley was describing

What would you guys ask him?

Mate, you are quite far in the process right? Everything is going well? Are you happy with how your Doctor treated you and everything, if yes then why are you worried? Just because some random interview in which Paley mentioned the country? Makes no sense to me imo you should have your own perception of the clinic by now.
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SpeedDialer

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Re: LL Complications Stream with Dr. Paley
« Reply #13 on: October 24, 2022, 01:31:05 PM »

Mate, you are quite far in the process right? Everything is going well? Are you happy with how your Doctor treated you and everything, if yes then why are you worried? Just because some random interview in which Paley mentioned the country? Makes no sense to me imo you should have your own perception of the clinic by now.

Gnail femurs have been fine I think, I think the knee pain and other problems will probably eventually go away, in particular I often feel amazing right after physical therapy. I'm assuming internal femurs are easier for the doctor than internal tibias which I'm thinking of doing in 1-1.5 years with Dr. Giotikas

Gotta wait and see what happens to the two precise tibia patients I know of here in Athens, they are like 1-3 cm into the process I think

I gotta find out about the things Dr. Paley said about the tibia/fibula fixation, wonder what Dr. Giotikas does for internal tibias for that. I can't remember if Dr. Paley said he fixes both ends of the fibula or something
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Vogel

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Re: LL Complications Stream with Dr. Paley
« Reply #14 on: October 24, 2022, 05:14:52 PM »

Gnail femurs have been fine I think, I think the knee pain and other problems will probably eventually go away, in particular I often feel amazing right after physical therapy. I'm assuming internal femurs are easier for the doctor than internal tibias which I'm thinking of doing in 1-1.5 years with Dr. Giotikas

Gotta wait and see what happens to the two precise tibia patients I know of here in Athens, they are like 1-3 cm into the process I think

I gotta find out about the things Dr. Paley said about the tibia/fibula fixation, wonder what Dr. Giotikas does for internal tibias for that. I can't remember if Dr. Paley said he fixes both ends of the fibula or something

Yeah he said both ends but just watch the interview again to make sure. He also said something about the entry point of the nail but to be honest I didn’t understand what he meant by that exactly.
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Vogel

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Re: LL Complications Stream with Dr. Paley
« Reply #15 on: October 24, 2022, 05:15:26 PM »

Has he ever spoke about Dr Mangal Parihar?

No
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AllinStryde

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Re: LL Complications Stream with Dr. Paley
« Reply #16 on: October 26, 2022, 11:46:09 PM »

Going to a 3rd-world country will yield you 3rd-world results. 
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kamaruusman

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Re: LL Complications Stream with Dr. Paley
« Reply #17 on: October 27, 2022, 09:11:05 AM »

Basically he trashed almost every doctor execpt himself;)

Except that mentioned he has a good experienced surgeon for external lengthening.


The only docs that he trashed are the one from New Delhi and Dr. D.

Where in the video did he mention Dr. D?
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LLprime3

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Re: LL Complications Stream with Dr. Paley
« Reply #18 on: October 28, 2022, 08:15:59 AM »

The screw to fix the fibula during the distraction, some doctors remove it after the lengthening period, and some don't.
How come this aspect is still controversial?

Those who have lengthened with a fixator, monorail or external, I saw both cases where the screw was removed from the fibula and at some cases it wasn't.

During the lengthening the screw has to be there 100%. But after that period, I can understand both cases, removing the fibula screw or let it there.

If the screw is still fixating the fibula, obviously the bone can not move and create a length discrepancy.
But if the fibula is fixed with two screws during the consolidation, the fibula has no wiggle room for moving sideways to match the movements of the body during the consolidation period. It's hard to explain, but the fibula has to have some range of motion to consolidate at the right angle with the other half of the fibula.
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SpeedDialer

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Re: LL Complications Stream with Dr. Paley
« Reply #19 on: October 30, 2022, 11:16:44 PM »

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