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[microman]

so i hear 0.66/day is the recomended maxium for tibs using external.

however some people are doing 1.00/day , if you do that, does that mean the distraction phase will be over quicker, BUT wont the recovery stage be a bit longer, so overall it ends up being the same total length of time anyway.

also has anyone managed to get 1.00/day on average everyday for the first 5cm.

[crimsontide]

1 mm is too much


i noticed considerably more pain when i attempted 1 mm. could only do it a day or 2

[Medium Drink Of Water]

so i hear 0.66/day is the recomended maxium for tibs using external.

however some people are doing 1.00/day , if you do that, does that mean the distraction phase will be over quicker, BUT wont the recovery stage be a bit longer, so overall it ends up being the same total length of time anyway.

also has anyone managed to get 1.00/day on average everyday for the first 5cm.

What you say is correct.  The bone won't fill in faster if you turn faster.  You'll just be waiting the same amount of time if doing external-only.  It'll help you get out of the frames sooner if you're doing LON though.

[microman]

ah okay so would this be an accurate assasment of doing around 5cm

0.66 for 3 months
consolodate for 5 months

1.00 for 2 months
consolodate for 6 months

so really it ends up being the same time, i guess the only advantage would be that you get to return to your country quicker if you were planning to go home for consolodation.

but yeah thanks for your advice on avoiding LON due to knee pain, with that i will be sticking to external or monorail.

[Overdozer]

No one turns 0.66 mm, when it comes to externals. Each turn of the screw is 90 degrees and 0.25 mm. Standard is 4 turns a day or 1 mm. Can be lowered to 3 turns which is 0.75 mm.

You also can't lower it to 0.75 if your consolidation rates are good. In fact, in some cases you have to increase the rate to 1.25 or higher if your consolidation is fast. Else you'll need another osteotomy to reopen your 'growth plates'.
http://www.paleyinstitute.org/?q=node/48

Premature consolidation: in this complication the patient bone bridges the gap and prevents further lengthening. Premature consolidation (PC) can occur with any method if the patient is a very rapid bone healer. The patient in these cases is able to make bone faster than the speed at which the bone is being lengthened.  The only way to prevent this is to speed up the lengthening intentionally for a week or two. The Precice nail with its rate control allows the surgeon to do this. If premature consolidation does occur it requires an outpatient small surgery to rebreak the bone through a tiny incision.

And obviously, if your consolidation rates are bad enough to allow a distraction rate of 0.75 mm or lower, that means you'll spend more time consolidating in externals, than someone who's able to turn 1.25 mm.

[microman]

how strange, i read the maximum was 0.66mm a day

I guess 0.75mm a day might be a decent compromise, but as you say that would make things worse, so i guess you are forced to do 1mm a day with externals?

but crimsontide said he could only handle that for a few days, so what would you have to do if you can't handle that, if you go lower, as you say that can affect consolodation in some way.

but i hope i can do 1mm anyway as that means only 50 days in russia.

but lets say i do do 1/mm a day somehow, does that mean

2 months lengthening
6 months consolodating

this entire time i thought it was 0.66mm a day

3 months lengthening
5 months consolodating

[Overdozer]

how strange, i read the maximum was 0.66mm a day

I guess 0.75mm a day might be a decent compromise, but as you say that would make things worse, so i guess you are forced to do 1mm a day with externals?

but crimsontide said he could only handle that for a few days, so what would you have to do if you can't handle that, if you go lower, as you say that can affect consolodation in some way.

but i hope i can do 1mm anyway as that means only 50 days in russia.

I didn't say it would make things worse. You don't decide at what rate to lengthen, it's your surgeon who's supposed to recommend the rate for you, judging by your callus formation. If you heal fast, you'll lengthen fast and remove the externals fast. And if you heal slow, you'll lengthen at a slower rate and it will take you more time to remove the externals.

Also, keep in mind that even if you do 1mm, you won't actually get full mm, due to pins/rods bending. You'll get more like 0.75-0.85 mm. And if you lengthen at 0.66 that will be around 0.4 mm/day and it will take you forever to lengthen.

[microman]

oh right I understand now, so it can be quite dynamic based on how your bone is healing.

had no idea about the fact that you get less height out of each turn like that, but suerly the weekly or so x-ray would confirm my exact real gain?

[Overdozer]

oh right I understand now, so it can be quite dynamic based on how your bone is healing.

had no idea about the fact that you get less height out of each turn like that, but suerly the weekly or so x-ray would confirm my exact real gain?

Yeah x-rays is where you can see how much you've actually lengthened. Just bring a metal piece with you that is the same length as your lengthening goal and put it on the same level with your bone. Lol j/k they've got their own metal centimeters.

[microman]

lol but i guess you can do that as well, but i hear even if you stand up during lengthening you can't assess your true height as you can't put your knees together?

[Medium Drink Of Water]

You do not have to lengthen in .25mm increments.  You can lengthen .66mm per day by turning the nut 2/3 of the way.  The fixators we had in Beijing were actually divided into sixths and had with knobs labeled with numbers 1-6.  "Turning 6" meant lengthening 1mm.  "Turning 4" meant lengthening .66mm.

[microman]

was the actual gain much lower though, like 0.4 mm/day for 0.66 turns on thne screw, cause then that's super slow.

but i will take advice from doctor anyway.

[Overdozer]

You do not have to lengthen in .25mm increments.  You can lengthen .66mm per day by turning the nut 2/3 of the way.  The fixators we had in Beijing were actually divided into sixths and had with knobs labeled with numbers 1-6.  "Turning 6" meant lengthening 1mm.  "Turning 4" meant lengthening .66mm.

Posts: 1337

OMG

[Medium Drink Of Water]

was the actual gain much lower though, like 0.4 mm/day for 0.66 turns on thne screw, cause then that's super slow.

but i will take advice from doctor anyway.

You get less than you turn because the pins through your leg bend.  This is caused by muscle resistance and/or putting weight on the pins when you stand/walk.  Fellow patients in Beijing kept track of all their turns on spreadsheets, but this was futile.  Their theoretical gain and their actual gain were always every different from each other.  I never bothered.  I just listened to Dr. Peng, who had me turning various amounts throughout my lengthening phase.  He started me at .66 but increased me to 1.33 by the end due to my good bone growth.