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[TIBIKE200]

After reading alot of diaries, I start to get the feeling that those who did externals with good docs and not an exagerated amount, had a much better long term recovery than those who did the same amounts in femurs (5-6cm).
 What you guys think?

[Knik]

i think external tibia with a good doctor safer than internal femur with a wrong doc

[TIBIKE200]

i think external tibia with a good doctor safer than internal femur with a wrong doc

 
  And if both are done with good doc? (I have the money to do it with Paley)

[Knik]

in is case it depends on your initial proportions

[Deads]

After reading alot of diaries, I start to get the feeling that those who did externals with good docs and not an exagerated amount, had a much better long term recovery than those who did the same amounts in femurs (5-6cm).
 What you guys think?

Tibias (internal or external) are more complex in general.

[texasbruce]

Yes and no.

Tibias is more complex but llizarov frame is good at correcting complications (and stable consolidation), but you might not recover as well due to complex muscles and tendons on lower legs

Femur is less complex but has risks like nail/stick bending, but you might recover your muscles better.

Recovery is really depending on your own, not the doctor (a little maybe) or the method. Do stretch before and a lot of exercise during and after.

[applesandoranges]

For internal femur I worry about my legs not aligned anatomically. Since all nails IM nails lengthen the femur bone mechanically. Fitbone, which is an exception, can lengthen anatomically but is inserted retrograde through the knee. I heard this causes permanent knee pain but I'm not 100% sure. If I can lengthen a safe amount under 4cm with Fitbone without permanent knee pain I would say its the safest option for long term leg function.

[alps]

can't Fitbone be implanted from the hips?

[TIBIKE200]

Yes and no.

Tibias is more complex but llizarov frame is good at correcting complications (and stable consolidation), but you might not recover as well due to complex muscles and tendons on lower legs

Femur is less complex but has risks like nail/stick bending, but you might recover your muscles better.

Recovery is really depending on your own, not the doctor (a little maybe) or the method. Do stretch before and a lot of exercise during and after.

As I said on another post, I have yet to see a single internal femur lengthening that I can call atleast "decent" (Dont mention me Shyshy because I don't believe him to be real but a fake diary). While all of the external tibias which were done by non indian doctors showed good results (Besides crimsontide's). Also, the external tibia lengthening is the method that is used in non cosmetic limb lengthening of children and adults with limb disprancies...

[texasbruce]

As I said on another post, I have yet to see a single internal femur lengthening that I can call atleast "decent" (Dont mention me Shyshy because I don't believe him to be real but a fake diary). While all of the external tibias which were done by non indian doctors showed good results (Besides crimsontide's). Also, the external tibia lengthening is the method that is used in non cosmetic limb lengthening of children and adults with limb disprancies...

I agree with you on the safety factor of the ilizarov frame.

But I do wanna mention that there are quite a few "decent" results in US with Paley and Precise nails. Plus precise nails are also used as limb discrepancies and FDA approved

[goldenegg]

If we're comparing the same amount of lengthening, I would choose internal femurs all day.  5-6cm in the femurs seems to be within a very safe limit and patients who lengthen that much seem to have really good recoveries.  whereas the same amount in the tibias is pushing it since the safe limit for tibias is less.  especially if you have to get ATL, which you may not fully recover from and Paley and Guichet seem to agree. 

Lastly, I wouldn't want to spend almost a year of my life in frames.  Externals are a much better price though compared to internals I'll give it that. 

[applesandoranges]

If we're comparing the same amount of lengthening, I would choose internal femurs all day.  5-6cm in the femurs seems to be within a very safe limit and patients who lengthen that much seem to have really good recoveries.  whereas the same amount in the tibias is pushing it since the safe limit for tibias is less.  especially if you have to get ATL, which you may not fully recover from and Paley and Guichet seem to agree. 

Lastly, I wouldn't want to spend almost a year of my life in frames.  Externals are a much better price though compared to internals I'll give it that. 

Yes I agree that femurs can manage a greater amount of length, but at what cost? If you lengthen the femur too much, say by 5cm, there will be a mechanical acis shift of 5mm which to me is a lot. For tibias, there doesn't seem to be an issue with the anatomical axis since tibias are straight.

Other doctors seem to be okay with Achilles lengthening so it might be a debataeble issue. If you keep it to 4cm or less you may not need Achilles lengthening either

[texasbruce]

Yes I agree that femurs can manage a greater amount of length, but at what cost? If you lengthen the femur too much, say by 5cm, there will be a mechanical acis shift of 5mm which to me is a lot. For tibias, there doesn't seem to be an issue with the anatomical axis since tibias are straight.

Other doctors seem to be okay with Achilles lengthening so it might be a debataeble issue. If you keep it to 4cm or less you may not need Achilles lengthening either

Agree. You can have a bigger lengthening on femur but still it is same for the soft tissues. You might appear to recover well but that is because your muscles are compensating the damage to the soft tissue.

[PatientZero]

Lastly, I wouldn't want to spend almost a year of my life in frames.  Externals are a much better price though compared to internals I'll give it that.

For many successful people, externals are more expensive than internals.

With externals, you'd want to hide from the general public for a year. Whereas with internals, you can probably go back to work in crutches at months 4-6, which represents a 6-8 months difference in lost wages.

Thats why I encourage all the young people to stop feeling sorry for themselves and work hard to advance your career and be in this position where externals are more expensive. Don't blindly go to a 3rd world country just cuz you have enough money.

Cheers