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[Bbabssann]

I'm a mother of a child with limb length discrepency and as I'm researching this topic came across this forum. 

First I want to thank you all for sharing your journey. It takes a lot of guts to be so honest and I am so grateful for your openness.

Because I don't want to go into this procedure blind or wearing rose colored glasses I am looking for the good, the bad and the ugly and am trying to decide which doctor and what procedure/nail would be best for my daughter. Since she is still growing and her short legs growth plates are nearly fused while her long legs plates are not we have 12-18 months before we can schedule surgery and I'm attempting to gather all the data I need to go in to this procedure with the most successful outcome.

So far we've visited two orthopedic surgeons and one doctor has measured a 4.2cm discrepancy and the other a 3.2 cm discrepancy both using their own x-rays/techs. One doctor sees primarily adult patients and the other works pediatric cases. Both doctors are located in Denver, CO and both do the precice nail procedure which is what I think we will end up doing.

So far, I've read Unicorns tragic journal and I truly hope that it all works out for her in the end and I've read penguins journal and his story has made me feel a lot more confident going the path of precice nail and I've begun reading/skipping around doingitformyself (I think) journal and have concluded there is a big risk of the bones not completing the healing process.

Here's my questions.

Would you do it again if you knew what your outcome would be?

What resources would you present to a friend considering these procedures.

If wearing a lift solved your issues with height or limb length discrepancy would you choose that instead of lengthening surgery?

I want to do what is best for my daughter and hope that you are willing to share with me your thoughts.

Thank you

Edit: I should clarify that it is her femur that has a discrepancy.

P.S. there are some stretching techniques that might help with some of the muscular complications I'm reading about called proprioceptive neuromuscular facilitation. 

[Overdozer]

Current concepts of leg lengthening

Poor regenerate formation is rare in young individuals: fast distraction (e.g. runaway nail), age >30 years, smoking, gain >4 cm, osteotomy at the same site of previous trauma or surgery and acute correction of associated deformities may be associated factors [19, 53, 63]. Partial or complete bony defects have been reported in up to 22 % for ISKD nails [19, 51], mostly due to inadvertent higher distraction rates (1.5 vs 1.1 mm). Pseudarthrosis is a non-event in most series [53, 60, 62]. It was prevalent in 3–8 % after Albizzia nailing [16, 59]. After the end of lengthening and after hardware removal, there is a linear increase of tensile forces. In animal experiments, mechanical stiffness only reached 50 % of normal bone 6 weeks after removal of the external fixator [102]. One of the most striking advantages of lengthening with solid intramedullary nails is the ease of both patient and doctor in terms of deciding whether a callus is already strong enough to avoid a refracture. The patients start to increasingly weight-bear at the end of the distraction phase anyway and the callus continuously builds up until nail removal, usually 1–1.5 years after the index procedure [16, 46, 50, 52, 62]. In case of external fixation, bazar-like negotiations about the right time for frame removal may come up if the healing index is high and the time with the external fixator in place exceeds the patient’s expectations. This urges early hardware removal with the inherent risk of fracturing a premature callus. Refracture after hardware removal may occur as osteoporotic stress fracture through regenerate bone, pins or a screw hole. The rate for unilateral and ring fixator ranges from 0 to 37 % [21, 24, 50, 65, 156]. Dynamisation of the frame, e.g. replacement of TSF struts with loosened Ilizarov rods or strut removal first to check if the new bone tolerates full load, may help as a preventive measure.

Get her fixed

[Body Builder]

3-4 cm is a big discrepancy than no lifts can fix.
So surgery is the only real solution. The only thing is if the discrepancy between the legs is only in one segment or ovth. If one leg has a longer tibia while the femur is the same in both, then your daughter could only do a tibia LL abd be ok.
The bad thing is if the difference in height is both in tibias and femurs and both these segments need an LL to meet the longer leg. There it needs both segment LL so 2 surgeries but still she should do it to fix her legs.

LL for discrepancies is much safer than cosmetic reasons as it involves only one leg and usually less than 4cm lengthening which is rather safe.
So find a good doctor for your daughter and everything will be ok.