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Author Topic: Plating or nailing the bones after lengthening  (Read 704 times)

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Bob

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Plating or nailing the bones after lengthening
« on: September 21, 2021, 06:56:05 AM »

What advantages have plating the bones after lengthening compared to nailing?
When can you do sport for example running after lengthening is finished and you have plate or nail on/in your bones?
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SirStretchAlot

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Re: Plating or nailing the bones after lengthening
« Reply #1 on: September 21, 2021, 09:19:29 AM »

There is little to compare. Both can be used to treat fractures, but only intramedullary nails can lengthen.

You cannot run or do sports for at least 4 months after lengthening, as the bone consolidates. Considering that nail removal occurs within a year, I would not run for at least 6 months after nail removal, unless you want your bones to snap.

What this means is that you should not expect to run long distances or do sports for 1.5 years. Non-weightbearing sports like swimming and rowing are completely fine though.
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May 2021: 171cm (evening) > September 2021: 181cm
Wingspan: 170cm | Male: 29 | 65kg | Based in UK
Femurs: Betzbone with Dr. Betz | ITB Release: Dr. Giotikas
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Michael J. Assayag, MD

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Re: Plating or nailing the bones after lengthening
« Reply #2 on: September 21, 2021, 10:08:55 AM »

What advantages have plating the bones after lengthening compared to nailing?
When can you do sport for example running after lengthening is finished and you have plate or nail on/in your bones?

after lengthening externally, lengthening and plating after can decrease the time in external fixator .

It can also be done if the regenerate is not strong enough, and it will prevent bending or breaking of the regenerate.

the trade off is that it increases the risk of deep infection by a lot .

it is however a very good method for delayed unions
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Dr. Michael J Assayag MD FRCSC
Limb Lengthening and Reconstruction Surgeon
http://www.heightrx.com https://www.limblength.org/conditions/short-stature
massayag@lifebridgehealth.org
IG @bonelengthening

eric.cartman

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Re: Plating or nailing the bones after lengthening
« Reply #3 on: September 21, 2021, 10:30:22 AM »

I have regular fracture nails in both of my tibias. Once I finished lengthening, my external frames were removed and fracture nails were inserted. Most fracture nails are (almost) fully weight bearing. I got rid of crutches one month after the nails were inserted and back in the gym lifting weights after two months. Obviously, I can't yet lift heavy weights but I'm comfortable lifting moderate weights without any problem and can do squats, deadlifts, leg extensions etc.
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Bob

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Re: Plating or nailing the bones after lengthening
« Reply #4 on: September 21, 2021, 11:48:38 AM »

after lengthening externally, lengthening and plating after can decrease the time in external fixator .

It can also be done if the regenerate is not strong enough, and it will prevent bending or breaking of the regenerate.

the trade off is that it increases the risk of deep infection by a lot .

it is however a very good method for delayed unions

I believe there is plating that is motorized so you can lengthen so you don't need external fixator. For example there is Precise plate (not available now). Correct me if I'm wrong but I believe today there is still other motorize plating available that you can use to lengthen without need for external.
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Michael J. Assayag, MD

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Re: Plating or nailing the bones after lengthening
« Reply #5 on: September 21, 2021, 11:51:59 AM »

I believe there is plating that is motorized so you can lengthen so you don't need external fixator. For example there is Precise plate (not available now). Correct me if I'm wrong but I believe today there is still other motorize plating available that you can use to lengthen without need for external.

2 different things.

Lengthening plates are for kids . i would not use them in adults as of now
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Dr. Michael J Assayag MD FRCSC
Limb Lengthening and Reconstruction Surgeon
http://www.heightrx.com https://www.limblength.org/conditions/short-stature
massayag@lifebridgehealth.org
IG @bonelengthening

Bob

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Re: Plating or nailing the bones after lengthening
« Reply #6 on: September 21, 2021, 11:54:55 AM »

.
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Bob

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Re: Plating or nailing the bones after lengthening
« Reply #7 on: September 21, 2021, 11:55:44 AM »

2 different things.

Lengthening plates are for kids . i would not use them in adults as of now

Any reason why you wouldn't use them in adults ?
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Bob

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Re: Plating or nailing the bones after lengthening
« Reply #8 on: September 21, 2021, 12:08:11 PM »

Any reason why you wouldn't use them in adults ?

My answer to my own question  :)

I think it's because it can be difficult to nail kid's bones, generally it's easier to nail adult's bones. So by using nail in adults avoids the risk of deep infection more compared to using plates.
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Bob

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Re: Plating or nailing the bones after lengthening
« Reply #9 on: September 21, 2021, 12:37:43 PM »

There is little to compare. Both can be used to treat fractures, but only intramedullary nails can lengthen.

You cannot run or do sports for at least 4 months after lengthening, as the bone consolidates. Considering that nail removal occurs within a year, I would not run for at least 6 months after nail removal, unless you want your bones to snap.

What this means is that you should not expect to run long distances or do sports for 1.5 years. Non-weightbearing sports like swimming and rowing are completely fine though.

Yes, it make sense - thanks.
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Michael J. Assayag, MD

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Re: Plating or nailing the bones after lengthening
« Reply #10 on: September 21, 2021, 05:32:15 PM »

Any reason why you wouldn't use them in adults ?

not strong enough for an adult bone

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Dr. Michael J Assayag MD FRCSC
Limb Lengthening and Reconstruction Surgeon
http://www.heightrx.com https://www.limblength.org/conditions/short-stature
massayag@lifebridgehealth.org
IG @bonelengthening

Shatter. Gee. 11

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Re: Plating or nailing the bones after lengthening
« Reply #11 on: September 21, 2021, 05:37:42 PM »

2 different things.

Lengthening plates are for kids . i would not use them in adults as of now
Thanks so much doc. The fact that you answer our questions on this forum really tells us how much you care about your patients. Really appreciate it. Thanks.
Slightly unrelated doc, but what is your opinion on externals on Femurs? Is it something we should avoid because of the pain or is it something inherently risky? I can tolerate pain.

(broke 22 year old here. Trying to save as much money as possible. Cant afford internals for sure. Will need to live off my dad if I go for internals)

Also, I know you probably wouldnt want to talk about other docs because of ethical reasons but Who according to you is the best doc in India? Would really help us in choosing a doctor that we can afford.
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Height now 166 cm
Desired Height 177 cm

Plan- LON tibia 6 cm, LON femur 5 cm

Bob

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Re: Plating or nailing the bones after lengthening
« Reply #12 on: September 21, 2021, 06:05:16 PM »

not strong enough for an adult bone

Thanks and thank you for your time in here  :)
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Bob

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Re: Plating or nailing the bones after lengthening
« Reply #13 on: September 21, 2021, 06:08:15 PM »

I have regular fracture nails in both of my tibias. Once I finished lengthening, my external frames were removed and fracture nails were inserted. Most fracture nails are (almost) fully weight bearing. I got rid of crutches one month after the nails were inserted and back in the gym lifting weights after two months. Obviously, I can't yet lift heavy weights but I'm comfortable lifting moderate weights without any problem and can do squats, deadlifts, leg extensions etc.

Best wishes.
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Michael J. Assayag, MD

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Re: Plating or nailing the bones after lengthening
« Reply #14 on: September 21, 2021, 10:02:42 PM »

Thanks so much doc. The fact that you answer our questions on this forum really tells us how much you care about your patients. Really appreciate it. Thanks.
Slightly unrelated doc, but what is your opinion on externals on Femurs? Is it something we should avoid because of the pain or is it something inherently risky? I can tolerate pain.

(broke 22 year old here. Trying to save as much money as possible. Cant afford internals for sure. Will need to live off my dad if I go for internals)

Also, I know you probably wouldnt want to talk about other docs because of ethical reasons but Who according to you is the best doc in India? Would really help us in choosing a doctor that we can afford.

thank you! I love limb lengthening with a passion.

I use to be quite involved in video games forums and mIRC back in the days playing Counter Strike and Day of Defeat in CAL (omg that tells you how old I am…) so being involved in an online community is second nature !

I tend not to comment on other surgeons as much as I can . I have met meet Dr. Parihar and Chaudhary many times and they are both great knowledgeable skilled surgeons.
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Dr. Michael J Assayag MD FRCSC
Limb Lengthening and Reconstruction Surgeon
http://www.heightrx.com https://www.limblength.org/conditions/short-stature
massayag@lifebridgehealth.org
IG @bonelengthening

Shatter. Gee. 11

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Re: Plating or nailing the bones after lengthening
« Reply #15 on: September 22, 2021, 01:42:56 AM »

thank you! I love limb lengthening with a passion.

I use to be quite involved in video games forums and mIRC back in the days playing Counter Strike and Day of Defeat in CAL (omg that tells you how old I am…) so being involved in an online community is second nature !

I tend not to comment on other surgeons as much as I can . I have met meet Dr. Parihar and Chaudhary many times and they are both great knowledgeable skilled surgeons.
Thanks doctor. Thank you so much.
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Height now 166 cm
Desired Height 177 cm

Plan- LON tibia 6 cm, LON femur 5 cm
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