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Author Topic: Has anyone done lengthening over plate  (Read 5162 times)

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Amorphous

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Has anyone done lengthening over plate
« on: October 02, 2014, 10:55:08 AM »

Hey Guys
I am new member, but following this and old forum  for quite a long time. Infact I was planning to join these forums for quite a long time, but kept procrastinating.

My height is 160 and want to add 5-6 cm to tibia (I want to keep within safe limits). I met Dr. Mandar Acharya in Pune (India). He discussed about Lengthening over Plate, which he prefer over LON. Since I never heard this technique discussed on either of forums, I am bit doubtful. Although the doctor explained me the things in details and I was impressed with his experience (mainly Distraction osteogenesis for deformities correction)and knowledge, I want to ask you guys, if you could provide me some suggestions.

I asked the doctor about his experience in cosmetic LL. He honestly told me that he do not have much experience in cosmetic LL, but he has been doing deformities correction and Distraction osteogenesis since 2002. He shown me many challenging cases he had handled and it was really impressive.

He also pointed out that the hospital site is recently updated for cosmetic LL.
Can you people suggest that whether I should go with the process. I am an Indian and prefer Pune over Mumbai or Delhi because Pune is not chaotic like Mumbai or Delhi and things are easier to handle their.
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Carter

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TRS

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Re: Has anyone done lengthening over plate
« Reply #2 on: October 02, 2014, 11:20:39 AM »

I am interested in plating too. I am quite reluctant with tibial nail insertion and the long frame time associated with externals.
The only thing that bothers me with plating is the scar that would be left behind and the lack of clinical studies.
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Overdozer

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Re: Has anyone done lengthening over plate
« Reply #3 on: October 02, 2014, 11:26:02 AM »

How do you imagine lengthening over plate?
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Pre-surgery - 167 cm, Post-surgery - 181 cm
Final arm span - 177 cm, Sitting height - 90 cm

Lengthened 7.5 cm in tibias and femurs and 3.5 cm in each humerus. Surgeries performed all external by Dr. Kulesh, in Saint-Petersburg, Russia - http://www.limblengtheningforum.com/index.php?topic=1671.0

Amorphous

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Re: Has anyone done lengthening over plate
« Reply #4 on: October 02, 2014, 11:33:10 AM »

Should I conclude that , Apart from scars LAP is better than LON..
Am I missing something ???
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Overdozer

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Re: Has anyone done lengthening over plate
« Reply #5 on: October 02, 2014, 11:35:52 AM »

Should I conclude that , Apart from scars LAP is better than LON..
Am I missing something ???
I don't see this construction being stable and weight bearing and you'll traumatize your bone regenerate when plating through it
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Pre-surgery - 167 cm, Post-surgery - 181 cm
Final arm span - 177 cm, Sitting height - 90 cm

Lengthened 7.5 cm in tibias and femurs and 3.5 cm in each humerus. Surgeries performed all external by Dr. Kulesh, in Saint-Petersburg, Russia - http://www.limblengtheningforum.com/index.php?topic=1671.0

TRS

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Re: Has anyone done lengthening over plate
« Reply #6 on: October 02, 2014, 11:43:48 AM »

Should I conclude that , Apart from scars LAP is better than LON..
Am I missing something ???
The safest and the least invasive way to lengthen tibias would be externals.
LON has the possibility of permanent knee pain from tibial nail insertion which LAP avoids.
Dr.Birkholtz did mention that newer plating techniques involve one 4cm scar and three-four 1 cm scars down the leg.
He also mentioned that one of the challenges with plating is the appropriate timing of plate insertion since plating can affect the regenerate.
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TRS

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Re: Has anyone done lengthening over plate
« Reply #7 on: October 02, 2014, 11:45:48 AM »

I don't see this construction being stable and weight bearing and you'll traumatize your bone regenerate when plating through it
I believe this is the reason why Dr.Parihar is strongly against plating
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Amorphous

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Re: Has anyone done lengthening over plate
« Reply #8 on: October 02, 2014, 11:55:43 AM »

Dr. Acharya had pointed out  it as a theoretical risk, but I hope that if a doctor has good experience with LAP, he must be knowing appropriate timing of plate insertion.
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Overdozer

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Re: Has anyone done lengthening over plate
« Reply #9 on: October 02, 2014, 11:58:13 AM »

"Appropriate timing of plate insertion" probably means waiting a few months in externals until your regenerate is strong enough. Might as well just wait another few months and take them off without plating.
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Pre-surgery - 167 cm, Post-surgery - 181 cm
Final arm span - 177 cm, Sitting height - 90 cm

Lengthened 7.5 cm in tibias and femurs and 3.5 cm in each humerus. Surgeries performed all external by Dr. Kulesh, in Saint-Petersburg, Russia - http://www.limblengtheningforum.com/index.php?topic=1671.0

GROWtalORdieTRYING1

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Re: Has anyone done lengthening over plate
« Reply #10 on: October 02, 2014, 01:21:03 PM »

the international ASAMI board.

if they are not on the list I would not even consider them.

even if they are on the list. diaries, consultations, and LL cosmetic experience is extremely important.


INDIA 
 
• Dr. G. S. Kulkarni
• Prof. H. R. Jhunjhunwala
• Dr. Milind Chaudhary
• Dr. Mangal Parihar
• Dr. R. K. Baruah
• Dr. M. Dhawan
• Dr. Ruta Kulkarni
• Dr. Suhas Shah
• Dr. R. A. Agarwal
• Dr. R. H. Govardhan
• Dr. Sandeep Adke
• Dr. P. N. Vasudevan
• Dr. J. J. Patwa
• Dr. Cherian Kovoor
• Dr. Ajit Patil
• Dr. Sanjay Das
• Dr. R. Kanaujia
• Dr. Rabi Jee
• Dr. S. Bhola
• Dr. R. Rohilla
• Dr. Harshad Shah
• Dr. Srinivas Reddy
• Dr. PNVSV Prasad
• Dr. Shibu John Varkey
• Dr. Yogesh Godbole
• Dr. Jitendra Bhatnagar
 
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GROWtalORdieTRYING1

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Re: Has anyone done lengthening over plate
« Reply #11 on: October 02, 2014, 01:23:38 PM »

Vice Presidents : Dr Mangal Parihar, Dr Ruta Kulkarni, Dr. Harshad Shah
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Amorphous

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Re: Has anyone done lengthening over plate
« Reply #12 on: October 03, 2014, 02:53:41 AM »

Vice Presidents : Dr Mangal Parihar, Dr Ruta Kulkarni, Dr. Harshad Shah

Thanks, I will see Dr. Parihar soon.
Still wondering, why such conflict of opinion is there among doctors. Some doctors prefer LAP where as other prefer LON.
LAP is looking a promising option to me (as per my discussion with Dr. Acharya), but still everyone is doing LON. I will discuss my doubts with Dr Parihar..
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Polycrates.

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Re: Has anyone done lengthening over plate
« Reply #13 on: October 03, 2014, 03:11:49 AM »

I'm not a medical professional, but I just can't see the merit to LATP in cosmetic cases. In trauma it is sometimes necessary, but in a controlled operation like LL, the plate's only merit is that it allows the fixator to come off early. It won't bear weight to the extent a rod can, so you'll still be bed ridden for quite some time. The scars and the fact that it is sure to be felt through the skin would also be things I wouldn't enjoy having.

I know people dread the insertion of  a nail, but if you have it put in by a good surgeon I don't think you should have too many problems with knee pain. Once you've worked in the scar tissue there shouldn't be any lingering pain- at least there wasn't in my case. Doctors have no qualms in putting nails into the tibiae of professional athletes, and they make full recoveries within months and continue to compete at a high level.
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Tibial LON for 6cm- Nov 2013, Dr Sringari -177/178cm to 183/184cm
Prospective Femoral Lengthening w/ Precise 3 (if out) Nail for 7cm- Jan 2019, Dr Birkholtz -183/184cm to 190/191cm

And it was here that he professed to his disciples: all of life's bounties lay somewhere upon the dreaded bell curve

ReadRothbard

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Re: Has anyone done lengthening over plate
« Reply #14 on: October 03, 2014, 02:02:22 PM »

This might be one of the most horrifying things I've seen in my life.
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“If you're afraid - don't do it, - if you're doing it - don't be afraid!” ― Genghis Khan

172 cm in the morning (67.8"); 170 cm (67”) at night; Sitting Height: 96 cm (37.8”); Goal: 184.5 cm (6'0.7"); Ultimate Goal: 192 cm (6’3.5) morning height, 190 cm (6’3) “night” height
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YellowSpike

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Re: Has anyone done lengthening over plate
« Reply #15 on: October 03, 2014, 06:47:03 PM »

This might be one of the most horrifying things I've seen in my life.

Agreed. That is some f#%ked up sh*t.
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