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[joax]

Hello,

I've been reading a lot about LL, but I have a few questions about doing external LL.

Question 1: As far as I understand, if you do external there's very little risk of permanent knee pain, is that correct?

Question 2: When you do external, you can expect to lengthen for maybe 2-3 months (depending on actual amount). Then once the lengthening period is over, they remove the frames and you don't have to do surgery again, is this correct? I'm a bit confused because I read that you have to go back to remove the nails, but I'm not sure if that only applies to internal or if you need another surgery for external as well.

Question 3: Is there permanent pain after doing external LL? What's the most common type of permanent pain?

Thank you.

[Blackhawk]

Question 1:  the knee pain comes from the surgeries to insert, and eventually, remove the internal nails.  I think some people choose to leave the nails in permanently though.

Question 2:  you have to keep the frames on while your bone consolidates.  If you lengthen 6cms in maybe 2.5 months you will have to keep the frames on for maybe another 5 months.  Some people say that expect to be in frames 1.5 months for every cm you lengthen.  But everyone is different so this rule may apply to you or maybe not.  Depends on how fast you consolidate.

Question 3:  I'm not sure if there is any permanent pain with external.  Maybe if something gets messed up and, for example, your alignment is off.  You could end up with x legs and have arthritis later in life.

[ForcedPuberty]

your not talking about pure external. which is the safest.

you are talking about LON, which is part external, part internal.


3 types:
1)external around 7 months in frames
2) LON  (external for lengthening phase ie 3-4 months, then internal for 1-2 years)
3) internal for a long time.


external is the only method to guaranty no knee pain. the other methods have a high knee pain rate.

 from clinical studies greater than 50% for retrograde entry for knee pain (because of damage to the patella).
 and around 17% for anterograde entry for hip pain.

there is 1 exception to external only knee pain. sometimes you get a terrible surgeon who puts the external frame on too close to the knee, because he will tell you "it gives better bone callous formation" which is true but still fked up if you get permanent knee pain. usually in the form of not being able to rest on your knees in a kneeled position.

[joax]

Thank you for your answers. It's a lot clearer now. So the main reason why people choose LON instead of external is the consolidation period, right? Everything else seems to be better for external, or is there something I'm missing?

[Blackhawk]

Thank you for your answers. It's a lot clearer now. So the main reason why people choose LON instead of external is the consolidation period, right? Everything else seems to be better for external, or is there something I'm missing?

That's correct.  Many people don't want to be in frames for 7+ months.  There is also the LATP (lengthen and then plate) method that avoids the knee pain associated with other methods.  There is discussion about this in the Dr Franz Birkholtz thread.

[KiloKAHN]

One drawback I've discovered with exfix only is that there's a good chance of getting constant inflammation just below the knees due to carrying the frames on your legs for so long. The inflammation gives heavy pain when moving your legs too fast or at certain angles. I forgot what the actual term was that my ortho told me, but once the inflammation comes up it won't go away permanently until the frames are removed. By month 5 I got this inflammation constantly below the right knee and starting just a few weeks ago I have constant pain and inflammation just below the left knee too.

You could get temporary relief if you take NSAIDs but I'm not allowed to take any right now.