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[Alittletooshort]

What time should I estimate in order to achieve a height increase of 3,5 cm per segment? I want to do this with two surgeries, oft which one should be in the months between july and mid-september 2015. Precise or anything too expensive is not an option since the height gain is probably not worth the extra money.
When could I be out of the frames if I did femurs or tibias with an exfix or Latp\Latn?

[Overdozer]

Both latp and latn are bad. If anything, you should lengthen OVER the nail (LON) and not insert it after the lengthening, as you'll lose height. Plating after lengthening is a joke, NO ONE does that. A general estimate will be 5 months for 3.5 cm lengthening, but with exceptional consolidation rate you could do it in 3.5 months, and with a bad rate it could be 7 months. With LON you'd remove the frames in a month.

[Alittletooshort]

I didn't know that LON does bring any advatages over LATN\LATP. Why would you lose height when the nail gets inserted after the lengthening phase?

[Overdozer]

I didn't know that LON does bring any advatages over LATN\LATP. Why would you lose height when the nail gets inserted after the lengthening phase?

You lose the height because your newly formed bone isn't strong enough and at the time of nail insertion/fixator removal, it compresses to some extent.

[jfk]

Both latp and latn are bad. If anything, you should lengthen OVER the nail (LON) and not insert it after the lengthening, as you'll lose height. Plating after lengthening is a joke, NO ONE does that. A general estimate will be 5 months for 3.5 cm lengthening, but with exceptional consolidation rate you could do it in 3.5 months, and with a bad rate it could be 7 months. With LON you'd remove the frames in a month.

It is not true that you can remove the frame in a month with LON doing 3.5 cm. Dont mislead people!!! It takes 2-3 months with LON before you can remove the frame.

[Overdozer]

It is not true that you can remove the frame in a month with LON doing 3.5 cm. Dont mislead people!!! It takes 2-3 months with LON before you can remove the frame.

What? With just 3.5 cm lengthened you can remove the fixator in 3 months without the nail lol. And there's no need of exfix after you're done lengthening.

[Alittletooshort]

So when will I be able to geht of the exfix? I'm a little confused right now.
What would the situation be like if I decided to do 5cms on my femurs (LON), since the regeneration is better due to the increased blood flow. (Getting out of the exfix)

[jfk]

What? With just 3.5 cm lengthened you can remove the fixator in 3 months without the nail lol. And there's no need of exfix after you're done lengthening.

LON on tibias works like that: 1 week after operation no lengthening + lengthening 3.5 cm (35 -45 days depending on complications, days of break etc.) + consolidation ( 2 - 6 weeks depending on regeneration, age, activity of patient etc.). Then the frame can be removed.

External fixator doing 3.5 cm in 3 months would be a rare exception. I have seen one patient doing 3.5 cm with exfix in 6 months. He was 40 years old. Depending on your age, activity and regeneration speed I would say it takes a minimum of 4 and maximum of 6 months to remove the frame with a external fixator on your tibias doing 3.5 cm.

External fixator or LON on femurs? Never seen that, no idea how long that would take. And I would not recommend it to anybody.

[jfk]

So when will I be able to geht of the exfix? I'm a little confused right now.
What would the situation be like if I decided to do 5cms on my femurs (LON), since the regeneration is better due to the increased blood flow. (Getting out of the exfix)

Hi,

from your posts I can see that you have no idea what you are getting yourself into. This is a serious operation that will be painful and take a long time! You need at least 6 months no matter how many centimeters you want to gain. I would recommend you to take one full year off. Read as much as you can about the procedures. First you need a lot of knowledge about it to make a good decision.

To answer your question, for femurs there is only one way to do this: Internal. Nothing else. All the other methods are complicated, very painful, risky and very very uncomfortable. For tibias you can do LON, LATN, exfix or internal. These are the methods that are practiced and well-known.

[Overdozer]

LON on tibias works like that: 1 week after operation no lengthening + lengthening 3.5 cm (35 -45 days depending on complications, days of break etc.) + consolidation ( 2 - 6 weeks depending on regeneration, age, activity of patient etc.). Then the frame can be removed.

You can lengthen 3.5 in a month by altering distraction rate between days 1/1.25mm (I did 1.75mm/day). And you don't wait for 'consolidation' with LON, as there's a nail to support your bone.

To answer your question, for femurs there is only one way to do this: Internal. Nothing else. All the other methods are complicated, very painful, risky and very very uncomfortable

It's not that complicated, or painful, or risky, but mainly uncomfortable - lets be objective here. For such a low lengthening amount, he could do cross-lateral tibia-femur and be done with 1st stage in about 5 months, with a 1 month lag-time before the next surgery it will 1 year total.

[jfk]

You can lengthen 3.5 in a month by altering distraction rate between days 1/1.25mm (I did 1.75mm/day). And you don't wait for 'consolidation' with LON, as there's a nail to support your bone.
It's not that complicated, or painful, or risky, but mainly uncomfortable - lets be objective here. For such a low lengthening amount, he could do cross-lateral tibia-femur and be done with 1st stage in about 5 months, with a 1 month lag-time before the next surgery it will 1 year total.

Just show me one guy who did it in one month and I will believe you. The problem is you talk  . You and no one in the world can do it in one month. Fact one.

Second: You cannot just stop lengthening and then remove the frame even when you have a nail in. You just talk   again. Fact two.

Guess why there are so few people who do external femur: Because IT IS risky and painful and complicated to do! 

You say LON can be done in one month and now you talking of doing "the first stage in 5 months" Why would you talk about cross-lengthening in 5 months when LON could be done in one month?

[Overdozer]

You and no one in the world can do it in one month. Fact one.

Second: You cannot just stop lengthening and then remove the frame even when you have a nail in.Fact two.

Alright, kid. Lets try again:
1. You get the surgery done. There's a 5 day lag-time before starting distraction.
2. You lengthen at a rate of 1 mm one day and 1.25 mm the other day. That's 31 day to lengthen. (1*15 = 15, 1.25*16 = 20, 15 + 20 = 35 mm = 3.5 cm)
3. You remove the external fixator and lock the nail. And yes, you can remove the frame right after you've completed distraction, as there's not a single reason for it to stay. That's 36 days total.

Read this carefully and learn to reason. Also I suggest you look up what the word 'fact' stands for. Because as a matter of fact, you have no idea.

(I leave the thread now)

[Alittletooshort]

I am looking for other options than internal methods, due to the fact that the amount of lengthening is simply not worth the money. With my starting height of 179/178 there is no need to to more than 3-4 cm´s per segment. Spending a minimum of 45 000$ for this amount just seems not worth the cash. Exclide, didn´t you lengthen your femur successfully with the exfix, at least one side so far?

[jfk]

Alright, kid. Lets try again:
1. You get the surgery done. There's a 5 day lag-time before starting distraction.
2. You lengthen at a rate of 1 mm one day and 1.25 mm the other day. That's 31 day to lengthen. (1*15 = 15, 1.25*16 = 20, 15 + 20 = 35 mm = 3.5 cm)
3. You remove the external fixator and lock the nail. And yes, you can remove the frame right after you've completed distraction, as there's not a single reason for it to stay. That's 36 days total.

Read this carefully and learn to reason. Also I suggest you look up what the word 'fact' stands for. Because as a matter of fact, you have no idea.

So now you talk of 5 weeks...okay...

That is a bunch of bull  you are writing and every doctor can confirm that. You cannot show me one person who did that and will never be able to because it is not possible!!!! Even if you do it the way you say you will need at least 2 months. The nail needs some bone formation around it to support it. If this was possible I would do 3.5 cm in one month, come back 2 years later after nail is removed, rebreak the bone and do another 3.5 cm in one month. Then I am 7 cm taller and had the frame on for 2 months! THAT IS IMPOSSIBLE! JUST BULL . Everybody knows that except of you. The best would be if you do it and show us how it is done. Revolutionise the world of LL for us please and do a diary. Full of crap and you still insist it is true.

[Medium Drink Of Water]

Alright, kid. Lets try again:
1. You get the surgery done. There's a 5 day lag-time before starting distraction.
2. You lengthen at a rate of 1 mm one day and 1.25 mm the other day. That's 31 day to lengthen. (1*15 = 15, 1.25*16 = 20, 15 + 20 = 35 mm = 3.5 cm)
3. You remove the external fixator and lock the nail. And yes, you can remove the frame right after you've completed distraction, as there's not a single reason for it to stay. That's 36 days total.

Read this carefully and learn to reason. Also I suggest you look up what the word 'fact' stands for. Because as a matter of fact, you have no idea.

(I leave the thread now)

This is not taking into account pin bending, or the fact that alternating 1mm/1.25 is brutal and could lead to non-union, or potential complications that force you to take a break from turning.  It's theoretically possible but practically unrealistic.

[Overdozer]

This is not taking into account pin bending, or the fact that alternating 1mm/1.25 is brutal and could lead to non-union, or potential complications that force you to take a break from turning.  It's theoretically possible but practically unrealistic.

I did 1.75 mm/day, started from 1mm, then I had to increase to 1.25 due to premature consolidation risk, then to 1.5 and finally to 1.75. My case was exceptional in terms of callus formation and soft tissue stretching, but I don't see how lengthening at a mean rate of 1.125 mm/day, which is just a 0.125 mm higher than the general recommended rate of 1mm/day, is unrealistic. Distraction rate differs from individual to individual, depending highely on callus formation and soft tissue response, but my point stands.

[jfk]

I did 1.75 mm/day, started from 1mm, then I had to increase to 1.25 due to premature consolidation risk, then to 1.5 and finally to 1.75. My case was exceptional in terms of callus formation and soft tissue stretching, but I don't see how lengthening at a mean rate of 1.125 mm/day, which is just a 0.125 mm higher than the general recommended rate of 1mm/day, is unrealistic. Distraction rate differs from individual to individual, depending highely on callus formation and soft tissue response, but my point stands.

My roommate is actually doing LON right now and even he says it would take about 3 months. You can tell your fairytales to people who have no idea of LL but not to people who have a good knowledge about that. You can take your mathematics and throw it in the bin because it is not working like that in reality. The biggest problem you miss is that you need a consolidation phase. Please just stop this "one month" thing. It is not even possible in theory.   

[spaller2015]

1-2 years to be fully recovered. IT depends on the amount you lengthen and on whether you do a one-phase or two-phase lengthening...

[tx1111]

It is not true that you can remove the frame in a month with LON doing 3.5 cm. Dont mislead people!!! It takes 2-3 months with LON before you can remove the frame.

What don't you get that the purpose of LON for cosmetic LL is to reduce time in frames. After distraction, the frames come out. If your lengthening 3.5 cm at a rate of 1 mm a day with no complications, the frames are on:

Surgery day
+~7 days to recover
+(x amount of millimeter lengthened)  In this case 3.5, it would be fair to assume 35-42 days in frames but unwise due to not accounting for complications.
Remove frames/lock nails into bones
Recover for I think 7 days.
Consolidate with nails only.

If your roommate is doing LON and he thinks he will be in frames for 3 months then he is probably lengthening 8 or 9 cm. When he is done distracting he will remove the frames.

That is if he is doing LON.
I am definitely doing LON.

[jfk]

What don't you get that the purpose of LON for cosmetic LL is to reduce time in frames. After distraction, the frames come out. If your lengthening 3.5 cm at a rate of 1 mm a day with no complications, the frames are on:

Surgery day
+~7 days to recover
+(x amount of millimeter lengthened)  In this case 3.5, it would be fair to assume 35-42 days in frames but unwise due to not accounting for complications.
Remove frames/lock nails into bones
Recover for I think 7 days.
Consolidate with nails only.

If your roommate is doing LON and he thinks he will be in frames for 3 months then he is probably lengthening 8 or 9 cm. When he is done distracting he will remove the frames.

That is if he is doing LON.
I am definitely doing LON.

You are talking in theory. I see practice.

Just shut up when experts talk.

Do whatever you like. I dont give a  .

p.s.: He is done lengthening since 2 months and has still frames on.

[Sweden]

I'm an expert. I've done LON. I've seen many patients done LON and my room mate even did LON on his femurs.

Forget about 1 month. If someone is lucky enough then 3,5cm can be done in ~6 weeks. The frame need to be attached one more week so around 2 months in frames for 3,5cm gain.

Totaly ridiculous if you ask me.
Why even bother messing ones body up totaly for 3,5cm and busting up both knees for life with the IMnail. Completely stupid!

If you're doing LON then go for at least 6cm. You'll look fine and has gained a respectable amount of height.

You'll regret your a$$ off when your knees ache every day and you've gained only 3,5cm - the same as in every Nike shoes there is.

[KrP1]

Sweden ..how.much time for 6.5cm with LON in tibias?

[Sweden]

You're back home after 5-6 months if all goes well.

If you stand up a lot during lengthening and stick to proper physio therapy then you can be home right after 4 months too - in wheelchair/crutches.

[TomD]

I'm an expert. I've done LON. I've seen many patients done LON and my room mate even did LON on his femurs.

Forget about 1 month. If someone is lucky enough then 3,5cm can be done in ~6 weeks. The frame need to be attached one more week so around 2 months in frames for 3,5cm gain.

Totaly ridiculous if you ask me.
Why even bother messing ones body up totaly for 3,5cm and busting up both knees for life with the IMnail. Completely stupid!

If you're doing LON then go for at least 6cm. You'll look fine and has gained a respectable amount of height.

You'll regret your a$$ off when your knees ache every day and you've gained only 3,5cm - the same as in every Nike shoes there is.

Hey Sweden!!! Glad you are here my friend. Sorry I havent come around for a few months. You are a warrior !

I agree. If we are going to do this, lets be honest. Gaining 2 inches is not worth it. Go in the mirror and stand on your toes a bit. Then ask yourself if that is worth the money, time , pain and rehab.

I dont think 3 inches is worth it but then again I am greedy. If I do tibs I will do femurs. Get 6 inches out of it. Some folks think 3 inches is good and I dont blame them. Its only half the time and cost.

But for me, I set aside 40k for femurs, 18k for tibs, and 2 to 3 years of rehab to be almost back to where i started physcially.

Considering most of you are in your 20s, its really NOTHING compared to your self esteem for 50 years after that. Food for thought. 

[tx1111]

You are talking in theory. I see practice.

Just shut up when experts talk.

Do whatever you like. I dont give a crap.

p.s.: He is done lengthening since 2 months and has still frames on.

Your not an expert either, your just like I am, seeing whats around us and r=drawing conclusions.

What are you talking about theory, I'm doing it right now. I bugged the hell out of my doctors pre op and still bother them post op about the process. When I speak about LON I am referencing him(who is the assistant surgeon and see almost everyday) and the Chief surgeon who I don't see as much. I ask all these questions because I want to know whats going on with me. I want 5 cm and they said at 1 mm a day not taking into  account complications and depends how well the callus forms around 8 to 9 weeks in frames and that includes post op recovery phase which sucked.

But fair enough you say your friend is done and I am barely 1 cm lengthened. i will post my diary in a couple of weeks and the doctors have told me barring issues, the frames will be out by 1st week of july. If somehow my doctors with all their credentials and experience are wrong, I will admit I was wrong and apologize to you.

Also I don't know if you understood but when you remove the frames, your not fully recovered or anything, your still crippled as fk and still have to recover/consolidate. That takes like 2-3 times as much time as being in frames. It is still a long process no matter what. That will be my case at least because the intramedullary nail I have is not fully weight bearing. I am not sure if other places have weight bearing nails.

also heres this

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2739482/

http://journals.lww.com/techortho/Fulltext/2009/12000/Tibial_Lengthening_Over_an_Intramedullary_Nail.10.aspx           (GENERAL CONSIDERATIONS AND PRINCIPLES  end of paragraph 3)

[jfk]

Your not an expert either, your just like I am, seeing whats around us and r=drawing conclusions.

What are you talking about theory, I'm doing it right now. I bugged the hell out of my doctors pre op and still bother them post op about the process. When I speak about LON I am referencing him(who is the assistant surgeon and see almost everyday) and the Chief surgeon who I don't see as much. I ask all these questions because I want to know whats going on with me. I want 5 cm and they said at 1 mm a day not taking into  account complications and depends how well the callus forms around 8 to 9 weeks in frames and that includes post op recovery phase which sucked.

But fair enough you say your friend is done and I am barely 1 cm lengthened. i will post my diary in a couple of weeks and the doctors have told me barring issues, the frames will be out by 1st week of july. If somehow my doctors with all their credentials and experience are wrong, I will admit I was wrong and apologize to you.

Also I don't know if you understood but when you remove the frames, your not fully recovered or anything, your still crippled as fk and still have to recover/consolidate. That takes like 2-3 times as much time as being in frames. It is still a long process no matter what. That will be my case at least because the intramedullary nail I have is not fully weight bearing. I am not sure if other places have weight bearing nails.

also heres this

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2739482/

http://journals.lww.com/techortho/Fulltext/2009/12000/Tibial_Lengthening_Over_an_Intramedullary_Nail.10.aspx           (GENERAL CONSIDERATIONS AND PRINCIPLES  end of paragraph 3)

That is a good post

I dont doubt that you will be off frames faster than with externals. I just dont see people getting off their frames right after (or not long after) lengthening as the theories say. All the cases I have seen are cases where they lengthen and then have the frame on for another 1-3 months. But this other guy said that you can get it off in about 36 days doing 3.5 cm. When I asked him several times if he has seen such a case he did not answer and ignored it.

But if you are correct and you will get the frames off not long after lengthening then I will also apologize to you and admit that I was wrong.

I hope you will do fine and get it off soon. I think it is a good idea to write a diary about it. Please do it. People must know how things work with LON. There is still some unclarity to it.

Good luck!

[tx1111]

thanks and I will