Me too. I'm transfering this topic to the Information section when the discussion peters out.
I think this thread will be a great read for future patients for years to come. I think we've pretty much covered everything as far as pros and cons, and prospective patients could really learn from this thread.
At the end of the day, what method you choose is entirely up to the individual. Nobody here can force anybody to do anything. My hope is that everyone is armed with all the information available, and then they can make an educated decision.
I think this is why it's the gold standard. It's way more convenient. And I definuitely do concede and never intended to imply otherwise that on average, the externals do have a greater chance of some complication (regardless of seriousness) occurring, since the average patient won't be as keen on self-care as I was. And for a doctor to assume the average will apply to any case before treatment begins is the most responsible way of thinking about it from his point of view, since he has no way of knowing in advance what the patient will do.
Another aspect to consider is that few Doctors in the west will do externals for cosmetic patients. Does anyone here know of a Doctor in the USA that will do externals for cosmetic patients? I don't know one. So you're left with butchers in Turkey that lack experience or proper training, who heavily advertise their cheap services and brand on social media, and they wind up getting a lot of uneducated patients who then develop complications. How many cosmetic patients are going to Turkey for externals, versus how many cosmetic patients are going to reputable Doctors such as Dr. Giotikas or Dr. Parihar for externals? If you're going to do externals, at least do them with a Doctor that knows that they're doing.
I think it's fair to say that the terrible reputation externals have are, at least by a decent percentage, due to the "Doctors" in Turkey butchering their patients. I say this disregarding any literature or studies.
As I said before, the Doctor and his medical team are going to play the biggest role in the success of your limb lengthening journey.
I have explained it a thousand of times on this forum.
Much less invasive method, almost zero risks for fat embolism which is the most fatal complication of LL and only one major surgery compared to two for internals (and 3 for latn especially).
Worrying about embolisms is completely valid. Embolisms are probably the worst complication you could get, yet they are also the rarest you can get. I remember Dr. Paley mentioning in an interview that everyone gets fat emboli, it's just that the extent do which they get it isn't enough to worry. It's only a problem when there's enough circulating to begin causing respiratory distress. Which is why things like your O2 levels are continuously monitored.
"Fat embolization occurs frequently following orthopedic trauma. Fat globules have been detected in the blood of 67% of orthopedic trauma patients in one study.[5] This number increased to 95% when the blood is sampled in close proximity to the fracture site.[6]"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3665122/Will external only patients have some fat globules enter their bloodstream? It's entirely possible.
The reason venting is performed prior to reaming or nail insertion is so that the bone marrow, which is essentially fat and the cause of fat embolisms, has a place to go. If venting isn't performed, then more of that fat will be forced into your bloodstream because it doesn't have anywhere else to go. As mentioned previously in this thread, the bone marrow in your femurs/tibias isn't critical, and once the nail is removed, it will regenerate. It's simply just not something you need to worry about.
What is the risk of embolisms for internals vs externals only? Do we have any studies or Doctors that talk about this? Obviously,
it's incredibly rare. But this might be what Medium Drink of Water sorta touched on before, in that it's a case of "we dont know". I'm completely open to whatever info you have on this.
Also the most stable method in terms of weight bearing and the best way to correct any malunions or problems you had even before LL as this is the main use of hexpods, to correct bones.
It is plain obvious why externals on tibias are for sure the safest LL method. Only merchant doctors say otherwise.
External frames are great for deformity patients. IMN's may not be suitable since they have to actually fit in the bone, and can only move on a single plane. If a patient has a severely deformed leg, may it be from birth or trauma, then a nail may just not work. So I agree with how versitile frames such as Hexapod frames (Good video:
https://www.posnacademy.org/media/Hexapod+External+Fixator+Deformity+Correction/1_tf5wdcy0 ) or TSF are, and they can absolutely be used to fix problems you had before LL,
we are cosmetic patients. If you are not a cosmetic patient, then what's pertinent to you is quite different.
It is plain obvious why externals on tibias are for sure the safest LL method. Only merchant doctors say otherwise.
I disagree. But I think this thread will be a great resource for prospective patients to make up their own mind and make an educated decision.
Author
Topic: What method of Limb Lengthening is best? Internal Nail vs LON vs External Frames (Read 3473 times)