Plating is used extensively in trauma patients and majority of them seem to be unilateral cases. However, there are only a few surgeons that are willing to perform LAP on normal CLL patients and that is why it's not very popular method. I think the reason why plating is not a preferred method for CLL by majority of the doctors is because of lack of clinical studies, questionable weight bearing capability and its effectiveness in adult bilateral cases. The following surgeons do offer plating as an option from the LL doctors directory:
-Dr.Birkholtz
-Dr.Inan
-Dr.Dhawan
-Dr.Shah
-(Dr.Rozbruch-I think he does offer LAP to CLL patients)
In this study by Dr.Rozbruch (
http://www.limblengthening.com/pdfs/Lengthening%20and%20Then%20Plating.pdf), the average external fixation index for both plating and pure externals is 1.5 and 2 months/cm respectively. Dr.Rozbruch notes the higher prevalence of regenerate collapse and varus deformity associated with plating, plus the two broken plates. Therefore the strength and the weight bearing ability of the plates is questionable.
Regarding the scars, Dr.Birkhotltz did mention that the scarring from plating would be the similar as nailing when using the minimally invasive plate osteosynthesis technique (MIPPO). However he did mention that the timing of plate insertion would be crucial in order to avoid harming the regenerate.
Personally, I think externals is the best option for tibias since it avoids the additional trauma from nailing or plating, but if you do have time constraints and cannot wear frame for the recommended duration, then consult a surgeon who is familiar and comfortable with both nailing and plating.