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Author Topic: Clinical Research On Lengthening and Then Plating  (Read 7825 times)

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TRS

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Clinical Research On Lengthening and Then Plating
« on: March 02, 2014, 08:20:25 AM »

Here is a study I found on LAP by Dr Rozbruch, Dr Fragomen and Dr Harbacheuski.
http://www.limblengthening.com/pdfs/Lengthening%20and%20Then%20Plating.pdf
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KiloKAHN

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Re: Clinical Research On Lengthening and Then Plating
« Reply #1 on: March 02, 2014, 08:33:44 AM »

Here's another study comparing plating with nailing.

http://www.ncbi.nlm.nih.gov/pubmed/21904230

It concluded that there was a higher rate of malalignment with intramedullary nails than with plates.
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Initial height: 164 cm / ~5'5" (Surgery on 6/25/2014)
Current height: 170 cm / 5'7" (Frames removed 6/29/2015)
External Tibia lengthening performed by Dr Mangal Parihar in Mumbai, India.
My Cosmetic Leg Lengthening Experience

Taller

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Re: Clinical Research On Lengthening and Then Plating
« Reply #2 on: March 02, 2014, 03:52:29 PM »

How are the plates inserted? I read in Sweden's diary that the plating process, carried out on another Dr. Sarin patient, left scars that made the leg "look like it had been opened by a grenade".
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Medium Drink Of Water

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Re: Clinical Research On Lengthening and Then Plating
« Reply #3 on: March 02, 2014, 05:07:56 PM »

The skin would have to be cut wide open all along the plate so all those screws can be put in.  You can't slide it in like a nail.

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jerry

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Re: Clinical Research On Lengthening and Then Plating
« Reply #4 on: March 03, 2014, 02:12:37 PM »

So is LATP actually better or worse than LATN/LON?
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TRS

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Re: Clinical Research On Lengthening and Then Plating
« Reply #5 on: March 03, 2014, 02:55:32 PM »

Here's another study comparing plating with nailing.

http://www.ncbi.nlm.nih.gov/pubmed/21904230

It concluded that there was a higher rate of malalignment with intramedullary nails than with plates.


Thanks Kilokahn :)

So is LATP actually better or worse than LATN/LON?

From the studies, LAP showed lower incidence of malalignment and deep infection compared to LON
LON has a high risk of permanent kee pain (30-50%) from the insertion of the IM nail which LAP avoids.
But the downside of LAP seems to be the scars that would be left behind from the plating.
Here is another study on LAP and LON
http://www.ijoonline.com/article.asp?issn=0019-5413;year=2012;volume=46;issue=3;spage=339;epage=345;aulast=Kulkarni

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Franz

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Re: Clinical Research On Lengthening and Then Plating
« Reply #6 on: March 03, 2014, 06:20:57 PM »

The skin would have to be cut wide open all along the plate so all those screws can be put in.  You can't slide it in like a nail.

Actually this is not necessarily true. Done properly, Plating is done using a MIPPO (minimally invasive percutaneous plate osteosynthesis) technique. This means a 4cm cut towards the outside of the knee and 3 to 4 smaller 1cm cuts down the side of the leg. Nailing would leave similar scars, namely a 4cm scar over the knee and four 1cm long cuts to introduce the screws.

Older methods of introducing plates would entail long cuts. Certain anatomic regions like the forearm require longer incisions.
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crimsontide

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Re: Clinical Research On Lengthening and Then Plating
« Reply #7 on: July 11, 2014, 05:31:45 PM »

if the scarring is not so bad according to dr franz, I'm thinking this might be my best bet
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Wannabegiant

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Re: Clinical Research On Lengthening and Then Plating
« Reply #8 on: July 18, 2014, 09:37:53 PM »

Here is another study of LAP and comparing it to external fixation. It seems to reduce time considerably, but a quite high risk of misalignment and even plate breakage. Depending on who does it and if they use a custom made stronger plate or not it might be a good idea.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3348329/ 
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TRS

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Re: Clinical Research On Lengthening and Then Plating
« Reply #9 on: November 10, 2014, 08:00:36 AM »

If modern plating is done as the following images show, then I guess plating is not a bad option at all. The images are from
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3377147/. Keep in mind that this is lengthening over plating and not lengthening and then plating.
Perhaps LOP may avoid harming the regenerate once the fixators are off.
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