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[ub40]

I have some questions on Precise II or Internals in general.

The most important question is, are they considered riskier than externals and is the overall process shorter? For example, the length of time for tibia with externals seems to be about 10 months when you factor consolidation would it be 6 months with Precise or less?

Would you guys recommend externals with LON or LATN instead?

I have heard of knee damage when using LON or LATN does Precise have the same risk? Is the added benefit, I could explore my area and be more active during consolidation or would I be bedridden still

My goal is to get everything done and then return home, but if I'm in an exotic country, it would be nice to explore a bit.

Thanks for the help guys

[Razorfin]

You first need to consider if you even have the budget for internal nails, these nails alone are the price of a down payment on a house. Guichet, for example, costs roughly 60-70 thousand pounds to have 2 Guichet nails on both tibia and femur. Life changing money, especially if you get into debt over it (highly unrecommended)

Internal nails will give you the benefits of not having much scarring present after lengthening. Plus the lengthening process is generally considered less painful and risky. The reason for the lower risk is that pin-site infections are non-existent with internal methods.

Mostly, the reason internal nails are favoured is because they have a lower chance of infection (deep bone infection is rare). They offer superior recovery and aesthetically pleasing results. They are more practical for purposes of moving around whilst lengthening. Plus having a massive frame attached to your leg may make you feel emotionally tormented that you are damaging yourself based on social constructs etc.

The overall process is usually shorter with nails as you can go home earlier and lengthen.

It all depends on what you can afford, there is a millionaire app developer on here who was able to go straight to Paley and have the best technology through Precise II .. however that may not be in your budget. Basically, get the best you can afford. Always save for the best doctor you can go with. But leave yourself a considerable amount of money for complications and Physio etc.

Knee damage is present in internal methods as the Patella tendon is split whilst tibial lengthening (and in some cases femoral lengthening) .. it is not guaranteed you will have knee pain. But to avoid it, you could get internals in your femurs and externals in your tibias. If I'm honest though I don't want to scar my lower leg too much.

Just remember that there are so many other things that you need to consider when lengthening, you are going to be basically crippled for roughly a year. That in itself can have it's toll.

[mrblack]

How much does Paley with Precise II  cost? Is this the best option of all? How much money should someone put aside for complications? Do you have to pay for all complications even if it is not your fault or are there any doctors who accommodate patients in such cases?

[blktville]

Hello MrBlack,
There's a Doctor's directory on this site.  here is the link: http://www.limblengtheningforum.com/index.php?topic=1753.0

According to the directory for Paley:
"The cost of surgery with physical therapy is $80,000 (Precice1) and $83,000 (Precice2) for bilateral femoral lengthening and $95,000 for bilateral tibial lengthening (Precice 1&2). For individuals who undergo femoral lengthening followed by tibial lengthening we offer a package price of $170,000 (Precice 1&2)." 

But you may have to contact his office to get updated info.  thx

[ub40]

Thanks for the very thorough response Razor

So my goal is tibias and I was thinking of going with external and LON or LATN for consolidation

I know internal femur is refommended here but my tibias are small already and lengthening would actually correct my proprtions. I also want to do a a moderate amount 6 cms. My goal is to travel to the location and stay for the surgery, lengthening and a small amount of the consolidation. Roughly 5 months and then be able to walk and go back to my old job without anyone knowing. Then come back for thr surgery to remove the nails a year later. Is this too optimistic. Will i be in crutches for a whole year? I would consider internals if it would speed up the process. What are your thoughts? It seems SA is the only place i can even come close to getting precise II