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[Exodus]

Which is the best option and why ? (Please also consider time frames involved)

[Medium Drink Of Water]

I think external-only is the best because it's the least invasive.  On tibia, anyway.

[Exodus]

I know, but for every cm of height, the external frame needs to be on for 2 months. So if you increase tibias by 5 cm, the external frame will need to be on for 9- 10 months

[ReadRothbard]

I though it was 1-1.5 months per cm?

[Kafka]

Why not internal ? Personally I think lenghtening in the femur should be a bit safer, cause there is more muscle tissue/flesh around the bone. Also I think, that it's better for the bone alignment to lenghten via an internal nail and since one has no pin sites entering the flesh it also should be better for the tissue/nerves/muscles as well ... (obvisiously Im no doc and might be wrong in my gut feelings)

 Of course internal is much more expensive, but faster as well ...

[Exodus]

I feel the risk of infection on LON is higher than internal nail

[Dr Monegal]

In my preferences

Number 1 internal
Number 2 LON
Number 3 ex fix only

This is straight forward. Having pins throught the skin onto the bone is high risk of infection.
100% of pins get superficial infection during the process.
So the longer they are in...the higher the risk is that this occurs.
With internals you do not have such circunstances.
LON shortens the period of external fixation.
And ex-fix only is a Long period until bone is healed. It Also caused axial deviations.
You might se hundreds of cases in which tibia deviates onto valgus after limb lengthenning.

I hope this can help you to decide what procedure suits you the most.

[GeTs]

In my preferences

Number 1 internal
Number 2 LON
Number 3 ex fix only

This is straight forward. Having pins throught the skin onto the bone is high risk of infection.
100% of pins get superficial infection during the process.
So the longer they are in...the higher the risk is that this occurs.
With internals you do not have such circunstances.
LON shortens the period of external fixation.
And ex-fix only is a Long period until bone is healed. It Also caused axial deviations.
You might se hundreds of cases in which tibia deviates onto valgus after limb lengthenning.

I hope this can help you to decide what procedure suits you the most.

If done 5cm wouldn't it be better to avoid the risk of knee pain by not doing LON and doing ex fix?

[joax]

I know, but for every cm of height, the external frame needs to be on for 2 months. So if you increase tibias by 5 cm, the external frame will need to be on for 9- 10 months

Yeah, where are you getting that fact from? I also thought it was lengthening + 1 month per centimeter. Any vets know what the average time is?

[GeTs]

Yeah, where are you getting that fact from? I also thought it was lengthening + 1 month per centimeter. Any vets know what the average time is?

I saw many diaries, and from day 1 to frame removal, this time divided by the lengthened amount, I found 1,34*every cm lengthened=time in frame to be pretty reliable,

[Dr Monegal]

Hi Halijah

That is a good point. If you mean knee pain caused by soft tissue stretching this might be the same. If you mean knee pain caused by patrullar tendon spreding you can avoid this by using a suprapatellar approach. If you mean knee pain caused by axial deviations, LON prevents you from axial deviations and ex-fix itself ends up sometimes onto tibia valga which might cause in the future knee artrosis.

I hope this Was helpfull.

[KiloKAHN]

I though it was 1-1.5 months per cm?

1 month per cm is typical for children
1.5 months per cm is typical for healthy adults
2 months per cm is typical for older individuals

[ReadRothbard]

That makes sense.