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[Emef]

I have seen that barinov's frames are very less compact with only rods of two circular frames getting in.whereas others frames are more complex with so many rods getting inside legs and I see that barinov's frames provide less scars.can anyone explain me clearly so I know the difference

[Medium Drink Of Water]

It can vary from doctor to doctor.  There's no standard configuration, so every doctor can customize them as he wishes.

[Emef]

I'd like to ask about scars since even I'm planning on have external tibias.are they still present.

[Medium Drink Of Water]

You'll get scars from external tibias, but fortunately they can be removed.  The pinsite scars actually get the best results from scar removal surgery because of their placement.  The scars related to nailing didn't go away as much.

[Emef]

So do you recommend LON or LATN to minimize nailing scars or they both produce same scars.

[Taller]

It can vary from doctor to doctor.  There's no standard configuration, so every doctor can customize them as he wishes.

What kind of scar is the nailing scar? Also, I remember you said that your knee pain was improving after six years. How much of it still remains?

[Medium Drink Of Water]

So do you recommend LON or LATN to minimize nailing scars or they both produce same scars.

Same scars, the only difference is when the nail is put in, not how.

What kind of scar is the nailing scar? Also, I remember you said that your knee pain was improving after six years. How much of it still remains?

I'm not sure what you mean by what kind of scar.  The nailing scars are located just below the kneecap and at the lower end of the shin.   These scars are in areas where the skin is thin and not very elastic, so they're likely to stretch out again if excised.

I hardly notice any knee issues at all anymore.

[Taller]

Thanks for getting back to me, MDOW. What I meant by "what kind of scar" are the knee scars, is what are the physical characteristics of the scars. Are they keloid-like? Is it a fine white line, or is it red? Is there any indentation or rise at the scar site? How generally noticeable are they?

[Medium Drink Of Water]

Thanks for getting back to me, MDOW. What I meant by "what kind of scar" are the knee scars, is what are the physical characteristics of the scars. Are they keloid-like? Is it a fine white line, or is it red? Is there any indentation or rise at the scar site? How generally noticeable are they?

The kind of scar depends on how your skin reacts to trauma, so don't assume you'll respond to the surgery the same as me.  My knee scars are thin white lines after two surgeries (one to insert the nail and one to remove the nail - I didn't have any scar revision surgery on those).  However, when I stand up with my knees locked, the knee skin falls down a little bit and casts a shadow, creating the illusion of an indentation directly below the kneecap.

[Taller]

In your opinion, is LON/LATN worth it for 5-6CM on tibiae? I know that ultimately it depends on how much risk vs time commitment one is willing to take, but what's your take on nailing, and at what point (or length) do you feel that the benefits of nailing generally become greater than the benefits of safety but long fixation time with pure externals?

Also, how much correction is possible with nailing? Part of my motivation to get tibial LL is to fix moderately bowed tibiae. But, I worry that the corrections might make nailing infeasible.

[Medium Drink Of Water]

I think all-external is always better because its issues are temporary, while the issues from nailing might be forever.

Quite a lot of correction is possible with LON.  I remember a guy in Beijing who was there mostly for corrections and just a little height, and he was getting LON just like everyone else there.  He said that was his reason for going with Dr. Xia instead of a doctor that uses internals - he could combine lengthening and correction into one surgery instead of having that be two surgeries with ISKD.

I'm not sure if the newer generation of nails available now are any better at corrections than ISKD, but those were his options in 2007.