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Author Topic: LON femur pros and cons  (Read 1314 times)

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erlang

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LON femur pros and cons
« on: December 14, 2023, 06:35:39 PM »

Hi, guys

I am planning to do LON femur lengthening with a monorail in Russia.

My details:
30 years, 60 kg, 170 cm
Goal: +6/7 cm
Arm length: 183 cm (really, lol)
Sitting height: 93 cm
Not sure if I'm measuring correctly, but it seems femur is 37 cm, and tibias with the foot are 45 cm.

I'm considering femur because tibias is not an option for me due to valgus deformation of the foot. Currently, I don't experience any discomfort, but there is a high risk that lengthening tibias could seriously aggravate valgus deformation.
PRECICE for femur is too expensive, approximately 30-40 average monthly salaries in Russia.
So, LON femur remains the option.

I found and personally spoke with one of the patients of a doctor with whom I plan to consult. He lengthened by 7 cm (166->173) and he is satisfied. Within a year, he fully recovered and resumed sports. Negatives included infection at the monorail attachment sites due to his own careless bandaging. He also mentioned another patient who was careless, started walking without support too early, and bent the nail.

I know many here discourage LON femur, mostly due to Turkish butchers, as I understand. However, I would like to understand the drawbacks of this method, aside from increased pain. I know there's a risk of lordosis, intraosseous infection (with any LON method), and high pain levels, but it seems that LON tibias has more risks – ballerina foot, nerve compression, risk of permanent knee pain, x/o deformation, and prolonged recovery.

I would appreciate hearing from veterans how reasonable it is to do LON femur in my case.
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Staystrong

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Re: LON femur pros and cons
« Reply #1 on: December 14, 2023, 07:56:48 PM »

Try to use search on this forum, about LON it was told many times :)
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TheDream

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Re: LON femur pros and cons
« Reply #2 on: December 14, 2023, 08:22:28 PM »

The average tibia to femur ratio is 0.80 with a standard deviation of 0.02 theres no way you have a natural one of 1.22 that equals a p-value of 10^(-98) of extremes which is 97 zeros in front of the 1.
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Beemer m3

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Re: LON femur pros and cons
« Reply #3 on: December 14, 2023, 08:23:18 PM »

the pins are adnormally big and goes through ur thigh. big hole mainly in the thigh rather then the bone like when u do tibia lengthening. recovery is alot faster but ur going to deal with lordosis back arching. alot of people complain on this forum about lon femur. but in reality people are still doing it because its the price that people think about. im thinking about it too but the scars is alot . good luck .
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before 168cm current 173.5 cm
ilizarov tibia
sept 2023

goal 2025-26 precice max femur

erlang

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Re: LON femur pros and cons
« Reply #4 on: December 14, 2023, 08:42:50 PM »

The average tibia to femur ratio is 0.80 with a standard deviation of 0.02 theres no way you have a natural one of 1.22 that equals a p-value of 10^(-98) of extremes which is 97 zeros in front of the 1.

Thank you for such a detailed analysis, apparently I’m actually measuring incorrectly.
I took a tape measure, but even according to the most daring estimates, the femur is no longer than 42cm

the pins are adnormally big and goes through ur thigh. big hole mainly in the thigh rather then the bone like when u do tibia lengthening. recovery is alot faster but ur going to deal with lordosis back arching. alot of people complain on this forum about lon femur. but in reality people are still doing it because its the price that people think about. im thinking about it too but the scars is alot . good luck .

How successfully can lordosis be treated?
Does it appear gradually, meaning I can stop the lengthening as soon as I notice that it has started to appear?

I'm not too worried about scars, I have very thick hair on my legs (sorry for the details)
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Beemer m3

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Re: LON femur pros and cons
« Reply #5 on: December 14, 2023, 11:17:49 PM »

i would start a month ahead doing sum lordosis exercises. since u have energy now u can do weight exercises. later on it would harder moving around from tight muscles.
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before 168cm current 173.5 cm
ilizarov tibia
sept 2023

goal 2025-26 precice max femur

erlang

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Re: LON femur pros and cons
« Reply #6 on: December 19, 2023, 09:09:46 PM »

I did a little research on the forum about lon femur and I want to give here a short summary of the main risks.

1. Fat embolism - there are risks only during surgery, pulmonary embolism - is rarely dangerous for healthy people, the risks increase when flying by plane.
http://www.limblengtheningforum.com/index.php?topic=65693.msg182778#msg182778

2. Relatively safe limit for femur 6-7 cm and then complications shoot up exponentially
http://www.limblengtheningforum.com/index.php?topic=75056.0

3. IT band release should be done on all femoral lengthening patients (otherwise knee contracture may occur)
Several posts by Dr Assayag and discussion with links to research:
http://www.limblengtheningforum.com/index.php?topic=73454.msg235657#msg235657
http://www.limblengtheningforum.com/index.php?topic=71643.msg223540#msg223540
http://www.limblengtheningforum.com/index.php?topic=65236.msg175674#msg175674
http://www.limblengtheningforum.com/index.php?topic=83610.0

4. the nail should be inserted through the piriformis fossa, otherwise there may be complications
http://www.limblengtheningforum.com/index.php?topic=71290.msg223120#msg223120

5. Risk of intraosseous infection with Lon femur 4% according to Dr Paley 3:05


6. Monstrous pain, I won’t even give links here, almost every diary talks about it

7. Hyperlordosis, which is also mentioned in almost every diary

8. Deep scars, which are pretty obvious

9. It’s also more complex to restore ROM and damaged muscles, but I haven't seen any links to research on this forum

10. With the last point I would like to add a little optimism and again refer to Dr Assayag, where he says that lon femur is painful and difficult, but can be an option with a good surgeon.
http://www.limblengtheningforum.com/index.php?topic=65523.msg179793#msg179793

For myself, I decided that I would save money for precice nail with Dr. Giotikas or Dr. Birkholtz
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Beemer m3

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Re: LON femur pros and cons
« Reply #7 on: December 20, 2023, 02:26:42 AM »

didnt know there was that much pain. i can do it in vietnam and do about 6 cm. but i want 7.5 the most. im just not so sure. also i think dr yuksel have the nicest lon monorail device. the pin looks thin.
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before 168cm current 173.5 cm
ilizarov tibia
sept 2023

goal 2025-26 precice max femur

Body Builder

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Re: LON femur pros and cons
« Reply #8 on: December 20, 2023, 11:59:51 AM »

PROS
better price than fully internals but it doesn't matter because

CONS
you will be ruined for life.

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1team

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Re: LON femur pros and cons
« Reply #9 on: December 20, 2023, 01:04:57 PM »

PROS
better price than fully internals but it doesn't matter because

CONS
you will be ruined for life.

What exactly is it about LON femurs which ruins you for life? Is it because it tears through muscle?
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CLLvet

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Re: LON femur pros and cons
« Reply #10 on: December 20, 2023, 04:13:08 PM »

What exactly is it about LON femurs which ruins you for life? Is it because it tears through muscle?

I would strongly advise against doing any sort of external frames on your femurs. I did do external frames on my tibias and that was fairly challenging. I feel that having external frames on your femurs would be a nightmare. 

I don't regret doing tibia LATN, because I had a good outcome. But I can tell you that the experience was more challenging to me than my first LL surgery (internal femurs). The external frames are just harder to bear. And again, having them on tibias is FAR easier than using them on femurs.

Finally, I also feel that LATN is a better option than LON. At times, LON can even prevent lengthening from occurring if the internal nail is too stiff/ large. There is also a higher risk for bone infection in LON (versus LATN).

If you have more questions about my experience with LON/LATN, you're also welcome to shoot me a DM, if you wish. I can't speak to surgeons in Russia, but I can speak to what it feels like wearing externals (on the tibias) if that's something you are interested in hearing more about. Best of luck.   
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174 cm (starting height), 188 cm (current height)

-8 cm femur w/ Stryde in 2019, with Dr. Giotikas (Greece)
-6 cm tibia w/ Taylor Spatial Frames (TSF)  Lengthening and Then Nailing (LATN) in 2023, with Giotikas (Greece)

CLLvet

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Re: LON femur pros and cons
« Reply #11 on: December 20, 2023, 04:17:43 PM »

I would strongly advise against doing any sort of external frames on your femurs. I did do external frames on my tibias and that was fairly challenging. I feel that having external frames on your femurs would be a nightmare. 

I don't regret doing tibia LATN, because I had a good outcome. But I can tell you that the experience was more challenging to me than my first LL surgery (internal femurs). The external frames are just harder to bear. And again, having them on tibias is FAR easier than using them on femurs.

Finally, I also feel that LATN is a better option than LON. At times, LON can even prevent lengthening from occurring if the internal nail is too stiff/ large. There is also a higher risk for bone infection in LON (versus LATN).

If you have more questions about my experience with LON/LATN, you're also welcome to shoot me a DM, if you wish. I can't speak to surgeons in Russia, but I can speak to what it feels like wearing externals (on the tibias) if that's something you are interested in hearing more about. Best of luck.


I should also add that I do speak Russian, have lived in Russia, and have a lot of knowledge about the country, so if that is something you are seriously considering, then again, please feel free to reach out...
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174 cm (starting height), 188 cm (current height)

-8 cm femur w/ Stryde in 2019, with Dr. Giotikas (Greece)
-6 cm tibia w/ Taylor Spatial Frames (TSF)  Lengthening and Then Nailing (LATN) in 2023, with Giotikas (Greece)

Body Builder

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Re: LON femur pros and cons
« Reply #12 on: December 20, 2023, 05:02:32 PM »

What exactly is it about LON femurs which ruins you for life? Is it because it tears through muscle?
Yes it tears through the largest muscles.of the body leaving permanent scar tissue there and of course it is barbaric to have external fixators in femurs for 3-4 months. Any kind of externals is a big no for femurs.
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Beemer m3

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Re: LON femur pros and cons
« Reply #13 on: December 20, 2023, 07:33:10 PM »

Didn't u do lon femur? Body builder? It's another option for short people.
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before 168cm current 173.5 cm
ilizarov tibia
sept 2023

goal 2025-26 precice max femur

Body Builder

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Re: LON femur pros and cons
« Reply #14 on: December 20, 2023, 11:31:17 PM »

Didn't u do lon femur? Body builder? It's another option for short people.
Of course no.
I did external only in tibias.

Short people if they don't have much money, they can do external tibias which is relatively cheap and very safe.
After than that if they still want extra height they should find money and do internal femurs. Otherwise they should accept their height after tibias and not ruin themselves.
If I had plenty money I would have done internal femurs too for 6-7cm, although I am ok with my current height. But I have much more important things to do with 50-60k euros and lon is simply not an option on femurs for any sane person. So I continue my life without regrets. If I ever win the lottery or earn a large amount of money and I am less than 50yo I may consider femurs with a fully.weight bearing magnetic nail. In no other instance though.
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Beemer m3

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Re: LON femur pros and cons
« Reply #15 on: December 24, 2023, 06:50:31 AM »

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before 168cm current 173.5 cm
ilizarov tibia
sept 2023

goal 2025-26 precice max femur
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