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Author Topic: Tibia or Femur?? Fastest method with least complications for 5cm lengthening  (Read 1891 times)

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jbc

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Hi everyone,

In researching LL for the past 4 months, I have scoured the Internet, various doctors' websites, read through the FAQs, and digested multiple threads from this forum. I have some questions that I hope can at least be addressed by members who have done LL by various methods.

My particular needs: I am 40 years of age and seeking a 4-6cm MAX lengthening. I'm in terrific physical shape, strong, muscular, and very flexible, with 7% bodyfat. I run, swim and rock climb, and can do exercises such as pistol squats, 40-50 pull-ups (normal ones, not the weird CrossFit ones) without breaking a sweat. I won't state my starting height, I will only say that I'm mentally very at peace with only doing 4-6 cm in order to minimize risks. This length increase seems to be the consensus not only from members of the community, but the thread compiled in this forum and various doctors' websites on the maximum lengthening that can be done with the least amount of risk.

I am seeking:

1) The fastest total in and out time from initial surgery to walking on my own, only with pins/nails left from removal
2) The fastest recovery time (I realize this also varies by individual)
3) The least amount of possible complications, during and post-surgery
4) The greatest chance for close to 100% back to normal recovery (I realize this may not be possible, and I'm totally OK with that, but would like to get as close as I can)
5) Given above, should the lengthening be done on tibia or femur, and using which method??

There is quite a bit of material on the latter. As examples, from Dr. Aimin Peng's FAQ:

Q: Which legs can be lengthened?
"Both tibiae and femurs can be lengthened. However, most techniques focus on the tibiae due to the lower risk of complications."

Then, reading Dr. Guichet's website:
"Tibia heals less easily and in far longer time than femur (less muscles around the tibia, thus less vascular supply). Femoral lengthening is preferred in cosmetic indications."

I am planning to go through the surgery in as soon as a few weeks, Dr. dependent. I plan to visit several - this is obviously a life-altering decision and I want to make very informed choices. Given that, your responses are very much welcomed and appreciated. As stated before, I will keep a full diary through the entire process, including post-op and recovery.

Many thanks,

--jbc
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OverrideYourGenetics

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Internal femur with PRECICE 2.2
« Reply #1 on: November 16, 2017, 08:45:42 AM »

It's been over a year so you may no longer be looking for an answer, but for others who discover this thread:

From what I've read so far, the femurs have a much lower risk of complications than tibias, and the safest surgeon is Dr. Paley. For 5cm at a distraction rate of 1mm/day, you're looking at ~5-7 days post surgery before distraction, plus 50 days for 5cm, so a total of about 2 months until the consolidation phase, plus (in Paley's estimate) 1 month before walking without crutches, and less than 3 more months before returning to sports:

Quote
Most patients can return to full weight bearing one month after a 5 cm femur lengthening and two months after a 5 cm tibial lengthening.
You have to regain your motion and then your muscle strength before returning to sports. If you work hard at this, you can go back as early as six months after surgery.

Note that the last sentence above doesn't mention the amount of lengthening, and I assume it's the maximum 8cm allowed by the PRECICE 2 nail.
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My diary. Tibias+femurs 3.75+3.75cm at the Paley Institute (5'5" -> 5'8") in my late 30s.
One of the last patients to use the PRECICE 2.2 nail. I met the first STRYDE patient and I strongly recommend the new STRYDE nail instead.
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