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[Uppland]

Does anyone have information about arm lenghtening?
I've read humerus is the easiest bone to lenghten but on the other hand haven't seen any patient who've done it with fully developed arms. Apparently people with damaged growth plates and stunted growth are less prone to problems while lenghtening because they're muscles are fully grown to fit with a longer bone.

On the other hand these people seem to be able to lenghten several inches without problems is this a safe alternative for cosmetic reasons as well provided you only do a few centimeters?

Do any of you consider doing it?
I'm cautiously interested because if my arms were only a few cm longer I would have much room to lenghten but I'm worried of how it might affect my arms. There is one diary on the old forum and it seems very successful but the patient had an underdeveloped arm to begin with.

[Disobedient]

as far as I can remember , carig49 did it .

[sadboy]

How tall are you and how long is your wingspan?
There are not many people who lengthen their arms for cosmetic reasons as far as I know.

[Uppland]

I'm 179 cm and my wingspan is 174 cm. My arms are 75 cm though which is normal. Dad is 187 and has 78 cm arms.

[Uppland]

as far as I can remember , carig49 did it .

How did that go?

[Greek-Semidget]

I'm 179 cm and my wingspan is 174 cm. My arms are 75 cm though which is normal. Dad is 187 and has 78 cm arms.

man my armspan is 180 and and height is 173 my arms look ok at my height (76-77cm each) I think you shouldn't do more than 5cm even that might be a lot...Your height is fine, but the choice is yours

[Uppland]

Well I don't mind having short arms within reason. There is nothing that says long arms look more attractive ,I actually think it's the other way around, but of course I don't want to go overboard.

Like I said though dad has 78 cm arms and while they do look short when you really think about it they don't look weird in any way. We both got long necks I guess so the arms look perfectly fine.

I'm lenghtening 4,5 cm to put less stress on my body but if I ever do 4 cm more I'd like longer arms.

[Greek-Semidget]

Well I don't mind having short arms within reason. There is nothing that says long arms look more attractive ,I actually think it's the other way around, but of course I don't want to go overboard.

Like I said though dad has 78 cm arms and while they do look short when you really think about it they don't look weird in any way. We both got long necks I guess so the arms look perfectly fine.

I'm lenghtening 4,5 cm to put less stress on my body but if I ever do 4 cm more I'd like longer arms.

dude listen to me being 6 feet...YOU WONT NEED MORE HEIGHT, its golden proportional and so on, do you know your sitting height? I am 92.5cm SE , 42cm Tobias 48cm femurs. Tell me about you

[Uppland]

I think my sitting height is 95 or 96 measured at night, my tibias seem to be 37 cm but I'm not sure how to measure them exactly. My femurs actually measure less but I'm not sure how much, overall I've got a large torso with short legs and arms.
I might have be off about some of the numbers though.

[GROWtalORdieTRYING1]

I would never get humerus lengthening with Dr Alex Monegal.

he did not answer the question correctly.

LON for tibia causes chronic knee pain in 25% of patients.

and he has not done LON before for humerus. im not going to risk permanent chronic pain in my arms.
if your going to do humerus I think it has to be pure external just like tibia.

[Uppland]

I agree, don't know much about humerus lenghtening but I wouldn't like any foreign body in my arms.

How didn't he answer correctly?

[Dr Monegal]

Hey there

Take it easy here. You might be doing proper use of the forum.
You are melting topics here. What does knee pain have to do with humeral lengthenning?
LON in humerus? I vas just saying this is technically possible but I do perform monolateral ex-fix
Have not done it yet. Have seen intramedullar devices prototypes for humerus, an LON is just a possibility.

So take it easy. And try not to melt topics out here.
You can write or say whatever, but what you have to understand is that for cosmetic lengthenning in most cases doctor choses the patient, rather than patient choses doctor.
I do really appreciate this forums and I am happy to take part to help you and to assess you to understand technical issues that are out of your knowledge. Most of the users do not have a clue about humerus lengthenning, and so you are one of those.
I have performed hundreds of procedures. So you can write here whatever you want from your ignorance. I don t care. You can decide to go to a doctor with no experience at all. But do not write anymorr stupid things in here please.

I must say you are reading my comments on a private message I wrote to Uppload. Can you guys do that?

Well this is very annoying from you guys. I try to help people asking questions and you publish private messages in here what for...to start talking about something you probably have not heard about before and start throwing stupid comments in the forum.
This should not be the purpose of it.

[Dr Monegal]

Hey uppload

Why did you just write this comment?
You are publishing private messages in the general forum?

I did not reply properly? I beg you pardon but you were requesting information about something you don t know, and you end up giving your opinion on what I said.
Read my PRIVATE message to you. I have performed monolateral ex fix procedures. I was just thinking about LON because this is technically possible and this shortens ex fix time. You where extremely pushy and concerned about recovery time.
I am shortly travelling to Scandinavia to perform a bilateral humerus procedure on request of one of my colleagues. I am not writting PRIVATE messages to you so you can start to say whatever.

My best advice to you can be to recommend you a good doctor in your country. I don t want privacy to be broken and that is why I wrote you in private.
You broke privacy after 2 emails so I am not happy at all.

Have a nice day and have a good chose of doctor. And please respect privacy when talking to doctors or having surgery. This is a must for professionals and should be for patients as well.

[Dr Monegal]

And please check your records. LON is performed in tibias as well.
Chronic knee pain in 25% of cases? That s well beyond the numbers in medical publications.
Try to insert nail throught a suprapatellar approach to prevent patellar tendon spreading and your numbers will go down almost to 0%

Enjoy the day. And do respect LL experts

[Uppland]

I'm sorry Dr Monegal I thought you wouldn't mind sharing what you told me. I would remove my post but for some reason I can't modify it, I guess there is a time limit on doing that -I'm really sorry.

Please know I never meant to give any offense or imply that you gave "wrong answers" I thought you did an exellent job on answering my questions and I just thought I'd share it so others could read them as well.

If a moderator reads this please remove my earlier post where I quoted Dr Monegal-

[123]

And please check your records. LON is performed in tibias as well.
Chronic knee pain in 25% of cases? That s well beyond the numbers in medical publications.
Try to insert nail throught a suprapatellar approach to prevent patellar tendon spreading and your numbers will go down almost to 0%

Enjoy the day. And do respect LL experts

Finally someone who can make these pseudo-intellectuals realize that they know nothing.

[GROWtalORdieTRYING1]

first Dr Monegal. you sound like you are a good doctor and will look after your patients very well.

you sound like you care.

but don't you DARE SIT THERE AND SAY THAT BECAUSE YOU ARE A DOCTOR that you must be knowledgeable in all areas of limb lengthening surgery and are above question. I have seen many doctors in my life and 1 thing is clear just because you are a doctor does not mean you know everything. in fact a great many doctors in different fields know very little about some things they are suppose to know and so second opinions are needed. this is a fact.

I am not even stating you don't know your stuff. what I am stating is you have no right to try and state that we LL patients don't dare question you because you are a doctor.

this is an LL forum. our job is to discuss LL surgery. in fact I was not even aware you had an account here. not that it matters.

now getting back to  the actual content of the discussion.

it is not my opinion. it is the opinion of SEVERAL WORLD CLASS DOCTORS, that a great many patients get chronic knee pain with LON!!! this is a fact.

and YOU HAVE NO EXPERIENCE WITH LON HUMERUS. and hence you cant really state that it is safe. we don't know if it is safe. we can only speculate.

I said I would never go with you because you to get humerus LON because you have no experience with it, and it would most likely replicate the problems with tibia LON due to anatomical similarities.

in fact to date we have had 1 patient that I know of who had internal humerus. sysop/apotheosis, and it did not turn out well for him.

so don't you dare sit there and state that I should be quiet and not even discuss LON humerus on a LL forum just because you are a doctor. we are here to learn. and learning comes from questions.

and too often we have heard doctors  HUNDREDS OF TIMES STATE you will be fine with such and such procedures, only to find out that the doctor was completely wrong. no sir being a doctor does not make you god. and unless you are a god you will certainly be questioned. especially on procedures you have not performed yet.

(1 final point. I have never heard of a doctor get angry by someone repeating information about surgical information or any kind of information in regards to a procedure or statistic or complication or any information about an operation in any way) doctor patient confidentiality does not in any way, shape, or form apply to this context. and it only applies to the patient.

its the same principle as the state can not preach religion, but individuals can preach religion.

a doctor can not discuss the patient. but the patient unless by contract can state what ever the hell he likes about a doctors opinion on an issue. you need to learn ethics on this matter doctor. you have done nothing wrong but you don't understand how confidentiality works. again this is an LL forum and we learn through discussion and questions. and problems arise when 1 doctor states differently to another doctor. at the end of the day it is up to a patient to choose a doctor, and for the doctor to agree to take him on as a patient. 

[Dr Monegal]

I do care about my patients, probably too much.
I am not god hahaha this sounds completely stupid to me.
What I was referring in my previous post is that my explainations to uppload were strictly private. I do not get mad with my patients. You cannot know that because you don t know me.
Here in forums you can discuss whatever. I do take part to help you guys ot there.
I was just making a comment about LON in humerus.
This is technically possible but haven t done it.
I have performed hundreds of procedures in humerus and I am always using monolateral external fixators. Perhaps I got confused thinking about patient asking about this technique in the past.

For your information shoulder joint is not even similar to knee joint.
If you want to talk about chronicle knee pain in LON i am completely aware of such complication and that s why I was suggesting a solution by performing a suprapatellar approach.

It is very annoying to read posts like "i don t like this doctor" or "this doctor will never operate me" without even knowing the person.
Being a doctor is a privilege, and this privilege is to help people like you out there. It is also big responsibility and we have to be carefull, precise and respectfull with the information we givento patients. And patients have also to be responsible and respectfull with the information they receive and that s why I don t like private messages to be published.
It takes a lot of time, effort and trainning to becaumr a doc and mor to become specialist in a specific area like LL. I do respect all my colleages and all my patients. I do respect all you guys and the forums because I know what you guys go through and that s why I joinned: TO HELP

That s why reading posts like yours or the ones that say "i don like this guy" is deserved by someone who is here to help. I do care about you guys.

Here everyone explains the part of his story that he wants to share. I can share hundreds of experienced I have had over the years. I can advice you in whatever reason you might need.
But I am not here to be judged.

So as I told you before, take it easy with LL and do respect LL experts. Because us, we listen and respect patients well beyond what you think.

[Taller]

Thank you very much for your response, Dr. Monegal, and thank you for helping us and contributing to our forum, even though you have no obligation to do so. I really appreciate your presence.

I was wondering why this supra patellar approach to LON isn't more common. Intramedullary nailing has been a procedure for over half a century, yet only now is supra patear nailing finally being discussed on LL forums, and only after several unfortunate cosmetic LL patients have suffered permanent knee pain from LON in their tibiae. What is your take on this matter?

[Taller]

I think my sitting height is 95 or 96 measured at night, my tibias seem to be 37 cm but I'm not sure how to measure them exactly. My femurs actually measure less but I'm not sure how much, overall I've got a large torso with short legs and arms.
I might have be off about some of the numbers though.

Uppland, do you know your father's sitting height and arm span by any chance?

[ShortyMcShort]

Agreed, thanks for your contribution on here Dr Monegal
And yes perhaps Uppland should have asked for permission first but whats done is done and im sure he's learnt his lesson
GROWtalORdieTRYING1 should not have said the things he said without even making contact with you. Assumptions are exactly that, assumptions

Are there two people typing responses for you Dr Monegal, I noticed one has good grammar and hardly any mistakes while the other is the complete opposite?
Not that it matters, just curious

Also could you talk more about this supra patellar approach to LON, more details on it on here? Or a private message is fine but on here would be better so everyone can be well informed.

Thank you

[Dr Monegal]

Hi shorty
It s always me. Nobody Is posting answers using my my account.
I don t have much time and sometimes I write fast and I use my cellphone. So perhaps that s the reason why there might be sone mistakes.

[Uppland]

Uppland, do you know your father's sitting height and arm span by any chance?

I don't know his armspan but his arms are 78 cm long, I think that's what really matters. His sitting  height is roughly equal to mine maybe 2-3 cm taller.

[Uppland]

Hi shorty
It s always me. Nobody Is posting answers using my my account.
I don t have much time and sometimes I write fast and I use my cellphone. So perhaps that s the reason why there might be sone mistakes.

Dr Monegal I thought I could remove you quotes after I posted them but apparently I can't.
Are you still upset that I posted them? I'm sorry but I couldn't think of a reason why you wouldn't share the information with the forum.

[Dr Monegal]

Hi uppload.
No worries. I am not upset to you.
What I say is that I am here to help you guys, and not to be judged or whatever.
That s why I write in private or I provide you my email address in most cases.
Take it easy and any question that may arise I will be more than happy to try and help you guys out there.

[Uppland]

I'm glad you're not upset and thanks again for answering my questions. I'm sorry if I were pushy in any way I'm just really cautious with my health in everything.

[KiloKAHN]

I guess the question would be whether or not LON on humerus would result in the chance of chronic pain. I'm not sure how they insert rods into the humerus, but the rod would have to be very thin. I think exfix only would be the best choice. I think a max of 4 cm per segment would be best for humerus lengthening and your fixation time should be brief. It has to be much easier than tibia lengthening because you retain most of your arm function and won't be bedridden. That's a huge point. You can walk around. 

[Uppland]

I'm no medical expert but I feel like a metal rod in the arms should be more intrusive than an external fixator. Am I wrong?

[GROWtalORdieTRYING1]

I think a max of 4 cm per segment would be best for humerus lengthening and your fixation time should be brief. It has to be much easier than tibia lengthening because you retain most of your arm function and won't be bedridden.

I completely agree.

i believe humerus lengthening should be done with monorail external fixators only. i don't see any advantage to LON on humerus, as you maintain function unlike leg lengthening, and you would be able to return to the gym much quicker than if you had to wait 1-2 years and then get the internal rod taken out.

what advantages do you guys see in LON humerus. i am curious?

[GROWtalORdieTRYING1]

actually 1 thing i don't know.

how long would it take to consolidate if you got 3.5cm on humerus (external only).

how long would you need to keep your frames on for?

assuming you do 1mm per day for 35 days. (or is this too fast)

dr monegal.

what rate do you recommend for lengthening humerus, and how long would you need to keep the frames on for?

thank you for your time.

[KiloKAHN]

actually 1 thing i don't know.

how long would it take to consolidate if you got 3.5cm on humerus (external only).

how long would you need to keep your frames on for?

assuming you do 1mm per day for 35 days. (or is this too fast)

dr monegal.

what rate do you recommend for lengthening humerus, and how long would you need to keep the frames on for?

thank you for your time.

Humerus is usually lengthened at the same rate as the tibia. I don't think I'd push it faster than .75 mm per day. Frames should require the same time (1.5 - 2 months per cm) or even 1 month per cm if you're one of the fortunate ones with fast consolidation.