After lurking for a while and having consultations with a couple of LL doctors, Ive come to the conclusion that this surgery is a crapshoot even by the best of doctors(and all doctors, even Dr Paley, somewhat downplayed the risk of complications). I believe that risks can be reduced (but not zero) as long as you do it in a western country with high standards of practice (if these doctors are routinely butchering patients like some claim, hospitals would have kicked them out). Especially internal femurs in the 5-7cm range, there doesnt seem to be a whole a lot of difference between western doctors and whatever nail they use.
As far as the difference in prices go, its worth noting that American hospitals are absurdly expensive. If you normalize the hospital fees, the price difference between the overall more expensive American doctors and slightly cheaper European doctors are reduced.
Another impression I got from speaking with patients is that even if they know about this forum or the old forum, most dont bother doing journals and they turn out decent. So you are not getting a clear picture from online one way or another. Its crucial to go visit the doctors and see the guesthouses and talk to as many patients as possible, and do so with a skeptical/critical eye. Then decide if its worthwhile.
I personally cannot even imagine doing this surgery in a third world country so I dont have much to add to that.