Topic: Which is the best LL method? (Read 23372 times)

Justkeepgrowing · « **on:** February 03, 2015, 06:04:52 AM »

In your opinion what is the best/safest LL method? I am reading that people who choose to do internal methods often experience knee pain. Why not go with the external method then? If I wanted to lengthen 5 cm on each of my femurs and tibias, and still be somewhat athletic, what method should I go for?

Overdozer · « **Reply #1 on:** February 03, 2015, 06:54:06 AM »

There aren't best methods really, it's only up to you to decide what you need. Internal devices mainly offer comfort and faster rehabilitation, while externals offer less-traumatic surgeries with less long-term complications, less surgeries, much cheaper costs and full weight bearing regardless of your weight. Say, you want to lengthen your tibias by 5 cm, here's how it looks like with both methods:
Internal: you'll be lengthening 2 months, the lengthening phase isn't much different from externals, as you'll severely limited in your movements. After another month or two, depending on your consolidation, you should be able to walk unaided and normal. So you can say the full recovery time with internals for 5 cm is 3-4 months. You'll want to remove the rods later on, but still.
External: you'll be lengthening 2 months, and you'll need another 3-4 months before you can remove the external device. So that's 5-6 months for 5 cm. Also keep in mind that while in externals even after the distraction phase you're still limited in your movement, clothings.

I guess it'll be fair to say that the overall rehabilition time is twice as long with externals. Like for 7.5 cm internally you'll need 5-6 months to start walking normally and with externals it'll be 10-11 months.

ItsMyLife · « **Reply #2 on:** February 03, 2015, 06:58:53 AM »

Quote from: exclide on February 03, 2015, 06:54:06 AM

There aren't best methods really, it's only up to you to decide what you need. Internal devices mainly offer comfort and faster rehabilitation, while externals offer less-traumatic surgeries with less long-term complications, less surgeries, much cheaper costs and full weight bearing regardless of your weight. Say, you want to lengthen your tibias by 5 cm, here's how it looks like with both methods:
Internal: you'll be lengthening 2 months, the lengthening phase isn't much different from externals, as you'll severely limited in your movements. After another month or two, depending on your consolidation, you should be able to walk unaided and normal. So you can say the full recovery time with internals for 5 cm is 3-4 months. You'll want to remove the rods later on, but still.
External: you'll be lengthening 2 months, and you'll need another 3-4 months before you can remove the external device. So that's 5-6 months for 5 cm. Also keep in mind that while in externals even after the distraction phase you're still limited in your movement, clothings.

I guess it'll be fair to say that the overall rehabilition time is twice as long with externals. Like for 7.5 cm internally you'll need 5-6 months to start walking normally and with externals it'll be 10-11 months.

with externals i could walk with walker from the night of the surgery, and i retained full mobility with walker until the 4 cm mark, when mobility became difficult at times due to knee contracture. still, i could sit at low places, reach down to take things,etc. Bagirov's frame is a modified device, so i retained full knee ROM because it is a very lean frame ( i could bend my knees back fully as there's no metal behind)

4 cm is done in 2 months, not 5 cm, and that is already having a considerable lengthening speed which is not advised by doctors (basically no follwing insructions)

but me and wannabegiant and maybe RGKey might be exceptional cases as the rest of the patients aboslutely hated externals..

Overdozer · « **Reply #3 on:** February 03, 2015, 07:14:28 AM »

Quote from: ItsMyLife on February 03, 2015, 06:58:53 AM

with externals i could walk with walker from the night of the surgery, and i retained full mobility with walker until the 4 cm mark, when mobility became difficult at times due to knee contracture. still, i could sit at low places, reach down to take things,etc. Bagirov's frame is a modified device, so i retained full knee ROM because it is a very lean frame ( i could bend my knees back fully as there's no metal behind)

4 cm is done in 2 months, not 5 cm, and that is already having a considerable lengthening speed which is not advised by doctors (basically no follwing insructions)

but me and wannabegiant and maybe RGKey might be exceptional cases as the rest of the patients aboslutely hated externals..

Well, you can walk with walkers with internals too, so I don't understand what you're trying to say. ROM isn't all that affected by tibial external lengthening, a whole different case is external femoral lengthening - which is, by the way, pretty much impossible to do bilaterally, which limits you to internals, if you want to lengthen your femurs.

The classic, standart lengthening rate is 1mm/day, so that's 60 mms or 6 cms in 2 months. I did 1.75mm/day on my femur.

Uppland · « **Reply #4 on:** February 03, 2015, 11:04:25 AM »

Would like to pinch in and say I've heard only bad things about doing external femurs, almost everyone does internal when lengthening that part of the leg.

It's true that internal tibis have a high chance of giving you minor but permanent knee pain -that will be for the rest of your life so think about that.

So basically I'd say:
-for femurs do internals with a good doctor
-for tibia do external and lengthen a bit less than your femur surgery to cut down on time.

GeTs · « **Reply #5 on:** February 03, 2015, 01:55:03 PM »

Uppland why u so greedy? U're 177, if u go Beyond 183 u Will regret it for the rest of your life

Uppland · « **Reply #6 on:** February 03, 2015, 01:57:12 PM »

Quote from: Hallijah on February 03, 2015, 01:55:03 PM

Uppland why u so greedy? U're 177, if u go Beyond 183 u Will regret it for the rest of your life

I am 178 at my lowest and I am planning to do 6,5CM internal femurs in one or two years. Doing a lot of stretching and saving money right now.

Been studying my proportions and 186-7CM is the most I would aim for considering I often wear thick boots (it's cold and snowy here). If I also lengthened my arms 3CM I could reach 188-9CM after that I think my legs will be too long. So all in all I have a decent idea of how my proportions will look and I'm certain they will hold up for an extra 6-7CM.

I think it's a reasonable goal personally but perhaps you know something I don't?

Overdozer · « **Reply #7 on:** February 03, 2015, 01:57:25 PM »

Quote from: Hallijah on February 03, 2015, 01:55:03 PM

Uppland why u so greedy? U're 177, if u go Beyond 183 u Will regret it for the rest of your life

It makes sense considering he's from Sweden. His 177 is ours 173.

Uppland · « **Reply #8 on:** February 03, 2015, 02:01:03 PM »

Quote from: exclide on February 03, 2015, 01:57:25 PM

It makes sense considering he's from Sweden. His 177 is ours 173.

Yes it's almost that bad unfortunately, I guess I feel like an 174CM guy in the states.

endomorphisme · « **Reply #9 on:** February 03, 2015, 02:30:40 PM »

what is your opinion on doing 4 cm on tibia with a russian doctor or an indian doctor who was trained by doctor paley?
And do you think someone who lenghten his tibia of 4 cm will have to do femur to balance his biomechanic.
Do you know doctors (i want name) who are really competent but whose fees are sub 30 000 dollars?

Uppland · « **Reply #10 on:** February 03, 2015, 03:26:33 PM »

Quote from: endomorphisme on February 03, 2015, 02:30:40 PM

what is your opinion on doing 4 cm on tibia with a russian doctor or an indian doctor who was trained by doctor paley?
And do you think someone who lenghten his tibia of 4 cm will have to do femur to balance his biomechanic.
Do you know doctors (i want name) who are really competent but whose fees are sub 30 000 dollars?

If you're asking me then you should first know that I am by no means an expert.

In my opinion 4CM is a very safe amount and you wouldn't need to balance it with additional lengthening. I know little of these russian and indian doctors so I really can't recommend or caution against them, am also unaware of any doctors in the sub 30 000 dollar price class. Sorry I couldn't be of more help.

Kafka · « **Reply #11 on:** February 04, 2015, 04:51:42 PM »

Quote from: exclide on February 03, 2015, 06:54:06 AM

externals offer less-traumatic surgeries with less long-term complications

How do get to this conclusion? it's only my opinion based on reading and talking to patients and docs, but I think that long-term complications are less likely with internals ...

Overdozer · « **Reply #12 on:** February 04, 2015, 06:57:54 PM »

Quote from: Kafka on February 04, 2015, 04:51:42 PM

How do get to this conclusion? it's only my opinion based on reading and talking to patients and docs, but I think that long-term complications are less likely with internals ...

Quote

Anterior knee pain is the most common complication after intramedullary nailing of the tibia. Dissection of the patellar tendon and its sheath during transtendinous nailing is thought to be a contributing cause of chronic anterior knee pain. The purpose of this long-term follow-up of a prospective, randomized study was to assess whether the prevalence and intensity of anterior knee pain after intramedullary nailing of a tibial shaft fracture is different in transtendinous versus paratendinous incision technique.

Quote

We reviewed 84 articles, of which 43 were suitable for critical analysis; eight referred to knee pain after antegrade femoral nailing (AFN),7,15,30,43,44,51,53,54 15 to retrograde femoral nailing (RFN)32,42–44,46,49,53–61 and 20 to tibial nailing (TN).

http://www.bjj.boneandjoint.org.uk/content/88-B/5/576
http://www.ncbi.nlm.nih.gov/pubmed/18545115
http://www.ncbi.nlm.nih.gov/pubmed/17473752
http://www.ncbi.nlm.nih.gov/pubmed/22068208
http://www.ncbi.nlm.nih.gov/pubmed/15891539

ReadRothbard · « **Reply #13 on:** February 05, 2015, 06:32:41 AM »

I think that the Guichet nail and/or Precice 2 are the best. They are also, of course, the most expensive.

greatheight · « **Reply #14 on:** February 12, 2015, 12:37:12 AM »

Precice 2, in my opinion.

Exodus · « **Reply #15 on:** February 15, 2015, 05:02:37 AM »

As from what I have see so far for Tibas it will be External and LATN

heightangel · « **Reply #16 on:** February 28, 2015, 01:57:32 PM »

Each method has its advantages and disadvantages, but I think that best method for femurs is Precice and the best method for tibias is Externals.

Aistro10 · « **Reply #17 on:** July 26, 2016, 06:45:14 PM »

So many people want to do Internal with precise 2. But it is too expensive unfortunately.

YourSpaceBoyfriend · « **Reply #18 on:** July 26, 2016, 07:19:18 PM »

Parihar does pretty cheap precise 2

KrP1 · « **Reply #19 on:** October 30, 2016, 09:08:59 PM »

internals in femurs

The Kaiser · « **Reply #20 on:** October 30, 2016, 09:19:57 PM »

Quote from: KrP1 on October 30, 2016, 09:08:59 PM

internals in femurs

+ expert doctor

BiggestProblem · « **Reply #21 on:** October 30, 2016, 09:29:26 PM »

Roses are red.

insearchofanswers · « **Reply #22 on:** October 30, 2016, 09:35:23 PM »

but there are white roses

HateLAPELoveSTEM · « **Reply #23 on:** September 02, 2021, 05:52:57 AM »

Said correctly Overdozer.
But in my opinion,internal methods for femurs and external methods for tibias are the best combination.

dexter1930 · « **Reply #24 on:** September 02, 2021, 09:58:18 AM »

Quote from: Medieval European on September 02, 2021, 05:52:57 AM

Said correctly Overdozer.
But in my opinion,internal methods for femurs and external methods for tibias are the best combination.

you're replying to those odd forum users, prbly they're all gone by now. Wonder how are these folks doing, did they do the surgery, if so how are they doing

HateLAPELoveSTEM · « **Reply #25 on:** September 02, 2021, 11:07:54 AM »

Quote from: dexter1930 on September 02, 2021, 09:58:18 AM

you're replying to those odd forum users, prbly they're all gone by now. Wonder how are these folks doing, did they do the surgery, if so how are they doing

I was just being informative and supportive for other active users still on this forum and they are viewing this post also.You can't ignore them except gone users.
My good personalities didn't capitulate to empty time.

Charliebetaller · « **Reply #26 on:** November 07, 2021, 10:35:41 PM »

Quote from: Sadist on September 02, 2021, 05:52:57 AM

Said correctly Overdozer.
But in my opinion,internal methods for femurs and external methods for tibias are the best combination.

what if I do really care about the pinsite scars on tibia?
Should I chose Precice tibia?

Medium Drink Of Water · « **Reply #27 on:** November 08, 2021, 01:24:23 AM »

Quote from: Charliebetaller on November 07, 2021, 10:35:41 PM

what if I do really care about the pinsite scars on tibia?
Should I chose Precice tibia?

Yes.

Unknown · « **Reply #28 on:** November 16, 2021, 04:04:46 PM »

Why do internal tibia usually cost more than internal femurs?

Limb Lengthening Forum

Author Topic: Which is the best LL method? (Read 23372 times)