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[GeTs]

I asked about scars. I don't understand, according to this forum internal femur are better for scares ?

"Good morning,

Whatever the method you will get some scares. With an external fixator there will be more scares but they will be smaller end can be removed more easily. You should not let this sole factor make you take your decision on the method.
You should rather consider all actors as risks and complications as well as scares.
I would suggest you to come and see me in order to talk about all these factors."

Doctor clearly says the 2 things:

Internal - less but bigger scars
External - more but smaller scars


In the later case, they are easier to remove according to his judgement.


What is it that bothers you ?

Personally I think one shouldn't be worried about scars more than function, pain, problems down the line and so on.

[weye32]

What is the price of femur LL with external fixator?

[Knik]

What is the price of femur LL with external fixator?

Are you sure you want to do that ?

[FDR101]

When the HEF is removed a splint is applied to the leg to protect the new formed bone.

Does anyone have information on this “split” Dr. Pili uses?

It sounds a lot less invasive than nailing, but does anyone know if there are drawbacks of this?

Also how big the split is etc.

[federico94]

Hi, I will have a individual consultation with Dr Pili in his studio for a limb lenghtening with his Ilizarov HEF.
If someone have some questions, just drop them.

[fivetenneeded2016]

Hi, I will have a individual consultation with Dr Pili in his studio for a limb lenghtening with his Ilizarov HEF.
If someone have some questions, just drop them.

I have two questions, could you please ask him:
1. can one go back to his country after 3-4 weeks and work(desk job). Does he recommend or have had anyone do so? provided the physios are religiously done.
2. can the 10-15% length compression(subsidence) be avoided by wearing the HEF frames longer?

[FDR101]

Hi, I will have a individual consultation with Dr Pili in his studio for a limb lenghtening with his Ilizarov HEF.
If someone have some questions, just drop them.

Hey Frederico, I have some questions regarding the split Dr. Pilli uses post lengthening with his HEF technique.

He says that:

When the HEF is removed a splint is applied to the leg to protect the new formed bone

Does this mean he does not insert a classic nail which is normally used in LATN (lengthening and then nailing) which a lot of other doctors use with externals?

If he says Yes, can you ask him:

1: What does the split look like?

2: Is it just 1 split or multiple?

3: What are the advantedges and disadvantedges of the split he uses compared to the classic nail most other doctors use?

Thanks.

[Body Builder]

This splint is after ilizarov removal. There js no real difference with what other doctors use and it has nothing to do with nails.
It should be a splint to keep the bone stable for about a month after ilizarov removal. If bone is fully consolidated is not even necessary imo.

[FDR101]

This splint is after ilizarov removal. There js no real difference with what other doctors use and it has nothing to do with nails.
It should be a splint to keep the bone stable for about a month after ilizarov removal. If bone is fully consolidated is not even necessary imo.

Thanks for your reply BB

I just have a hard time understanding how a “split” holds the bone stable.

I always picture the nail inside the bone sealed with screws that we see a lot of examples of from LATN and LON diary’s.

From what I understand Dr Pili does not insert a nail into the bone which is then hold together with screws. So I can’t really understand / picture how a split is inserted to hold the bone stable

[3inchhope]

"The HEF has to be kept in place for the all duration of the treatment till full consolidation is achieved. Usually it takes around 100 days for lengthening up to 8 cm and 5-6 months to achieve a full consolidation. During the lengthening time the patient will walk with crutches and follow our rehabilitation protocol to avoid muscle contractures such as ballerina foot".

Can anyone confirm at what point I would be walking again and able to move on my own?

Id be traveling from near the UK to Italy for this surgery so im trying to determine how long I would be staying there?

So my understanding is that I would in the HEF fixator twisting the pins however required for a period of 100 days. What happens though during the subsequent 5-6 months consolidation phrase that follows?

Would I still be in the HEF fixator or is it removed after lengthening? if not is it only removed after the 5-6 month consolidation period?

Im not sure what id tell my family but im thinking id say im going traveling for a year as it looks like it will be a good 9 months before I could return home.

Many thanks for any help provided

[onemorefoot]

"The HEF has to be kept in place for the all duration of the treatment till full consolidation is achieved. Usually it takes around 100 days for lengthening up to 8 cm and 5-6 months to achieve a full consolidation. During the lengthening time the patient will walk with crutches and follow our rehabilitation protocol to avoid muscle contractures such as ballerina foot".

Can anyone confirm at what point I would be walking again and able to move on my own?

Id be traveling from near the UK to Italy for this surgery so im trying to determine how long I would be staying there?

So my understanding is that I would in the HEF fixator twisting the pins however required for a period of 100 days. What happens though during the subsequent 5-6 months consolidation phrase that follows?

Would I still be in the HEF fixator or is it removed after lengthening? if not is it only removed after the 5-6 month consolidation period?

Im not sure what id tell my family but im thinking id say im going traveling for a year as it looks like it will be a good 9 months before I could return home.

Many thanks for any help provided

You Will keep the Ilizarov rings for all the lengthening And consolidation phase, so near a year

[3inchhope]

"During the lengthening time the patient will walk with crutches and follow our rehabilitation protocol to avoid muscle contractures such as ballerina foot"

Ok so i understand that I can expect to be in HEF frame for the guts of a year.  So would it be correct from the above to assume that after the 100 days of lengthening that you would still be in the frames but be able to walk without crutches?

Im guessing you would be walking like frankenstein though with frames still on so if out in public would probably be better to use crutches.

Also I think I read that frames can be removed from your own surgeon at home. This seems quite odd to me as im not sure how this could be done?

Im from Ireland and in my country, your doctor makes a referral to a hospital, they take and xray and schedule surgery if needed to fix an injury or condition.  There are long backlogs as it is so its not like you can rock up with some frames around your legs, saying you got limb lengthening and surgeons will just remove frame.

Id personally be too embarrassed to explain it all to my local doctor so id hope Dr Pili could remove them when that time comes.


Dr Pili does list some possible complications and how they can be resolved. I suppose my two greatest fears would be fat embolism and any non union complications leading to amputation.

Are these risks still a real possibility or is it safe to assume that with modern surgical procedures being followed they can be eliminated?

[federico94]

I have two questions, could you please ask him:
1. can one go back to his country after 3-4 weeks and work(desk job). Does he recommend or have had anyone do so? provided the physios are religiously done.
2. can the 10-15% length compression(subsidence) be avoided by wearing the HEF frames longer?

Hi, you can of course do desk job. After a couple of days you can go home safely.

[federico94]

Hey Frederico, I have some questions regarding the split Dr. Pilli uses post lengthening with his HEF technique.

He says that:

Does this mean he does not insert a classic nail which is normally used in LATN (lengthening and then nailing) which a lot of other doctors use with externals?

If he says Yes, can you ask him:

1: What does the split look like?

2: Is it just 1 split or multiple?

3: What are the advantedges and disadvantedges of the split he uses compared to the classic nail most other doctors use?

Thanks.

Hi, what you can split, wich is splint, is a device used for support or immobilization tool wich can be made of plastic and other material, or by making a fabric bandage that you wear to cover the leg. It is basically a guard, to protect the leg and the new bone. So you will wear one for leg.
I'm not aware of what other doctors do, if he don't do it probably there is a reason. I suppose that you need a surgery to put a nail on, so the answer it's pretty simple.
Have a nice day

[Random Hero]

Gentlemen,

Thought this information from emailing Pili might help others; please see below.

i)                    How many millimetres of lengthening would you advise for optimal recovery whilst achieving a good height gain? (I train at a Muay Thai Boxing gym 3 days a week and would like to continue with this sport after surgery).


It depends on your wishes and on the way you will react to the procedure. However 6-8 cm is usually a good gain.

 
ii)                   Once the distraction / lengthening phase is complete can I return to England whilst consolidation takes place and provide you x ray images via email?

Yes, you can, but you will have to come and see me when I will ask you to. Usually once as month.

 
iii)                 Can you provide an up to date price for Hybrid External Fixator for tibia?

19-25.000 depending on where is the main procedure performed.

 
iv)                 How many physiotherapy sessions are required? Once, twice a day?

2-3 a week will be enough.

[The Dreamer]

Thanks a lot,Random Hero !
Have you already done a consultation with him ?
I will follow carefully your case since your starting height it is not very different from mine and since I live in Italy

[KiloKAHN]

RH, CLL will kill any chance of being competitive in Muay Thai. Your stamina will drop, your legs will be more sensitive to impact, and they'll feel heavier because your quads have to put in more work to move longer shins. Don't do it if muay Thai is still important to you.

[Random Hero]

Thanks a lot,Random Hero !
Have you already done a consultation with him ?
I will follow carefully your case since your starting height it is not very different from mine and since I live in Italy

No worries; we are all here to help each other 
I'm going to set up a consultation as soon as my work schedule dictates hopefully in next two months.

Ah nice! I would have never had known you were Italian as you can write better than me (native English speaker)! Haha

[Random Hero]

RH, CLL will kill any chance of being competitive in Muay Thai. Your stamina will drop, your legs will be more sensitive to impact, and they'll feel heavier because your quads have to put in more work to move longer shins. Don't do it if muay Thai is still important to you.

It would be an extremely proud moment to fight in the Thai stadiums at some point but I've passed my prime sadly so little point in perusing that avenue.
I'd just be happy with one or two amature bouts now and then but I am aware I will be at a disadvantage.
As long as I can still defend myself about and about on the street against yobs that's good enough for me.

[Random Hero]

Anyone know how much the consultation cost is?

Looks like it's only 30 minutes long too judging by his website which is a bit odd.

[ShortArm]

Round 200-300€. Send him a email and ask, he is a fair dude.

[Random Hero]

Double post

[Random Hero]

Round 200-300€. Send him a email and ask, he is a fair dude.

Tyvm; booked a date now in Milano but no mention of fee.

That price seems very reasonable Guichet was £300 but it lasted nearly 2 hours if I remember.

[HD]

What about internal femurs with pili? There are some experiences?

[Shadow91]

I'm looking for the same thing.

[HD]

Good, its strange that noone know nothing.

[Shadow91]

Yeah, it really is.

[myloginacct]

Am I wrong or is doing CLL with the HEF only a purely external procedure? As in, LATN or LON are not available options. From the text, it seems obvious that it is, but it doesn't hurt to ask.

Also, I'm sure Pili or his assistant would reply to your inquiries about doing internal femurs under his care. Contact is provided here.

[determination]

He does also internal Nail with Stryde.
I have met at least 3 patients doing this method with Pili.
They looked quite pleased with this method but mobility looks better with HEF, especially at the beginning.
https://drpiliortopedico.it/en/allungamento-con-chiodo-endomidollare-allungabile/

[please]

Does anybody knows how much Pili charges for internals?

[exagerate]

Does anybody knows how much Pili charges for internals?

He charges:
20-22 k for HEF on tibia
48-50 k for Precice II
57-60 k for Stryde
Prices are in EURO

I had HEF procedure myself on tibia and got 8.3 cm
Now I am planning to do Stryde on my femurs to do another 6-8 cm