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[Taller0318]

I am halfway through lengthening right now.. and I was wondering if i should get nails or not. After nailing.. how long does t take to walk like normal? I am not talking about extensive activities right here.. just wondering how long does it take,  for me to walk without crutches. Will there be much pain walking all the time? Thanks

[doomsday]

everyone is different but i would say around 3 or 4 months in average. Also it depends how much you lengthened and whether you have ballerina foot or not.

[Body Builder]

Be a little more patient and don't do LATN.
You'll need 3-4 months with externals only but then you'll completely over.
LATN doesn't worth the extra surgeries and risks.

[doomsday]

I disagree, after lengthening i had my frames for over 11 months and i did only 4 cm

[Body Builder]

I disagree, after lengthening i had my frames for over 11 months and i did only 4 cm

You are an exception.
Ibhad my frames for 11 months too but I lengthened 7.5 cm.
For 4 cm someone needs 5-6 months max if nothing bad happens.
You'll need an average of 40 days per cm.

[Taller0318]

everyone is different but i would say around 3 or 4 months in average. Also it depends how much you lengthened and whether you have ballerina foot or not.

thank you for your advice. fair enough... did you choose to do nailing yourself?

[Taller0318]

Be a little more patient and don't do LATN.
You'll need 3-4 months with externals only but then you'll completely over.
LATN doesn't worth the extra surgeries and risks.

i might also do big lengthening... like you did. I wonder if LATN could accelerate the rate of consolidation?

[kakahi]

I think there are many factors. Can be as low as 2 months to walk completely normal like Sibirsky. And he did 8 cm on tibias and had bad knee contractures. But maybe ballerina plays a role cause he said he didn't have bad ballerina

[Body Builder]

i might also do big lengthening... like you did. I wonder if LATN could accelerate the rate of consolidation?

Nails make consolidation slower. Bone consolidation with externals only is the fastest you can get.

[Bander72]

If your doing 5 cm I dont see why latn would be bad. The doctor  can do corrections on your leg before he inserts the nail while with lon its done all at once and dosent give that chance. If your doing more than 5 then I would reccomend to do the traditional method.

[LLSouthAmerica]

Nails make consolidation slower. Bone consolidation with externals only is the fastest you can get.

That's not correct. There are plenty of studies that say that bone healing is faster with LATN than with pure externals. However it is True that pure internal vs pure external favours the latter.

Advantages of LATN are less time with frames, safer recovery post frame removal, less joint contractures, faster healing

Disadvantages are having an extra surgery, risk of DEEP infection (due to combining both methods), require more experience from surgeon. Finally RISK OF PERMANENT ANTERIOR KNEE PAIN

This is why i think its better pure external for tibia.

[Taller0318]

That's not correct. There are plenty of studies that say that bone healing is faster with LATN than with pure externals. However it is True that pure internal vs pure external favours the latter.

Advantages of LATN are less time with frames, safer recovery post frame removal, less joint contractures, faster healing

Disadvantages are having an extra surgery, risk of DEEP infection (due to combining both methods), require more experience from surgeon. Finally RISK OF PERMANENT ANTERIOR KNEE PAIN

This is why i think its better pure external for tibia.

Hi there.. thank you for your response. I wonder what might lead to deep infection? if the surgery is properly performed.. does it naturally lead to infection?

[Bander72]

He means the nail could get infected which could be severe because it is inside you  while pure external theres nothing inside you that would get infected.

[LLSouthAmerica]

He means the nail could get infected which could be severe because it is inside you  while pure external there's nothing inside you that would get infected.

In external there is the possibility of deep pin tract infections which are on average 1-2 per patient (almost all patient have infections), however the majority are superficial and easily treatable. Nonetheless they could go deeper.

In LON, because there is an external and internal device at the same time there is a greater risk of deep infections because there is contact from outside the skin (due to the pins) and the intramedullary nail which can be colonized with bacteria. The treatment in this case is removal of the nail and parenteral antibiotics for a prolonged time.

In LATN, the risk is lower because most of the times there is not concurrent internal and external device. Even so there is a greater risk than with pure internals. If a pin infection develops during lengthening in LATN is has to be treated prior to IM insertion. Even being careful, sometimes there is bacterial colonization but not yet infection so it could go pass unnoticed. Then with the IM insertion is could progress to a deep infection.

THE POINT OF MY POST IS PERMANENT KNEE PAIN!!! Forget LATN or LON

[Bander72]

Your talking like its 100% guarantee that you will get knee pain lol. The reason people say internal tibias is bad is that there is a 25% chance of getting knee pain. With lant, it is less chance than that. Anyway if someone is aware of the risk and wants to proceed then its on them. I sure as hell don't want be so many months in those frame for 4-5 cm gain and willing to take a risk as we all take risks when we do this surgery.

[doomsday]

Birkholtz was explaining in one post how often the knee pain actually occurs and its seems to be marginal  with the new techniques.

[LLSouthAmerica]

Birkholtz was explaining in one post how often the knee pain actually occurs and its seems to be marginal  with the new techniques.

Yes apparently with the new approach for tibia nail insertion the risk is much less, that's why we have some fitbone users here who have had a positive experience with pure internals. I don't know if there are newer case studies using these techniques.

Your talking like its 100% guarantee that you will get knee pain lol. The reason people say internal tibias is bad is that there is a 25% chance of getting knee pain. With lant, it is less chance than that. Anyway if someone is aware of the risk and wants to proceed then its on them. I sure as hell don't want be so many months in those frame for 4-5 cm gain and willing to take a risk as we all take risks when we do this surgery.

I always say RISK which in itself means it is not a 100% guarantee. However, I also read that there is a 30% chance (in some studies even more) of getting permanent anterior knee pain. I think a person who is aware of this and still do this procedure which in itself does not alter the cm gain, only reduces the time with frames is very unwise.

It's definitely on them but they don't know what it is like to live with pain everyday every time they walk. I think you will admit that being a few months with a device in your legs is better than having pain for the rest of your life. This added risk is stupid because we do the surgery for height boosting to the point of endangering our lives, and LATN only adds another risk.

[onemorefoot]

Suprapatellar approach is maybe what you are talking about. IMO pure external tibias is the best way, being with an Ilizarov fixator for a year is not funny surely, but is worse having a Deep infection or permanent pain. LATN is a good way, but there is too much trauma, LON is not very good, if you get a misalignment you are f++++d as hell.

[Bander72]

Yes but there is no 100% garauntee for the surgery itself. And as doomsday said birkholtz who would know the most about this said that risk is becoming more marginal so I doubth that it is anywhere close to 30%.

[kakahi]

I think the risk for knee pain is about 14%

[Lord Vader]

The light side of the force clouds this thread from the truth. I sense great fear in you, but risks must be taken. Would you rather walk in as little as 3 months, or spend up to a year in those torture devices to risk no pain? You will feel pain, regardless