not sure why you feel the need to keep rationalizing externals over internals...
paley himself prefers internals for cosmetic lengthening and has described the shortcomings of externals compared to internals in his research
"external fixators are plagued by high complication rates secondary to pin-tract infections, associated risk of deep infection, neurovascular injuries, prolonged treatment time until removal, muscular and soft-tissue transfixation that lead to contractures and stiffness, pain and discomfort, refracture after removal of the fixators, as well as, psychosocial burden, requirement to perform daily pin cleaning, and physical awkwardness"
the main testimonial on the paley institute website is a guy who successfully did quad internals complete with links to youtube videos of his athletic recovery. his diary is on the old forum too. unless of course you want to accuse that of being fake too like shyshy. there's also oldiebutgoldie and yellowspike off the top of my head. I dont understand why but there are a number of successful internal femur recoveries out there that you're refusing to acknowledge
Paley also reccomended a max of 5 cm for femurs once... Than extended it to 6.5 and now to 8.5... The funny thing is that this max safe limit is the same as the max of the nails he helped create.
No, I dont believe every internal diary is fake... I only said it about shyshy's diary. I dont have any proof... It's just my own feeling and it does not mean it's the truth...
Yellowspike hasnt recovered yet and betz's diaries arent to be fully trusted with all the things that happened there regarding Sysop/apotheosis and betz's agreements...
Paley's research contradicts Catagni's research about the safety of the external method (which btw, is still used much more worldwide in treating deformeties and disperancies in adults than internal methods).
Rozbruch, Paley's and even that fraud Dr. Mahboubian used externals in their "most famous" success stories on youtube.
About deep infections, it is much more common with internals than with externals for the simple fact that the internal nail is inside the bone. The superficial infections are easily dealt with.. Neurovascular damage is due to bad surgeons with lack of knowledge of anatomy.
And if Paley who treats 150 patiens a year for cosmetic reasons has only one success story on his main website, it means something (and it's not positive in my opinion).
Btw, if you search on Paley on the web you will see that he was kicked out because of some fraud or something from the hospital he used to work in.
Do I advocate externals? Yes, but only for tibias (internals do seem the better solution for femurs). But the only thing I do advocate is to go to the best surgeon possible (not thinking about budget because money is not an issue here).
I have chosen Catagni to be the only possible choice (If will do this surgery... I will decide after consultation) because he (with prof. Cattaneo) are the ones that imported limb lengthening from Ilizarov himself to the rest of the world. Catagni and Cattaneo were the ones that tought this method to the rest of the western world (even Paley says it) and as of today, there is almost no one that is as an expert on this technique as much as him(I mean external tibias).