Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[Unknown]

From what I gathered and read up on these topics, correct me if im wrong
Tibias:
Pros
Better sleep(lower legs less affected by bed movement)
Less pain(?)
More recommended for externals and LON(lower budget)
Cons:
Lengthening limit lower compared to Femurs(6 compared to 8?)
Tighter stretching
Higher risk of fibula and tibias not aligned completely

Femurs:
Pros
Higher lengthening limit(8cm)
Better recovery rate(?)
Better proportions femurs to tibia ratio
Cons:
Usually additional procedure(IT band release, required)
Considerably more painful
Lengthening around soft tissues area on thigh could make it harder to sleep
More expensive due to only being recommended on internals

Is that more or less accurate?

[SpeedDialer]

From what I gathered and read up on these topics, correct me if im wrong
Tibias:
Pros
Better sleep(lower legs less affected by bed movement)
Less pain(?)
More recommended for externals and LON(lower budget)
Cons:
Lengthening limit lower compared to Femurs(6 compared to 8?)
Tighter stretching
Higher risk of fibula and tibias not aligned completely

Femurs:
Pros
Higher lengthening limit(8cm)
Better recovery rate(?)
Better proportions femurs to tibia ratio
Cons:
Usually additional procedure(IT band release, required)
Considerably more painful
Lengthening around soft tissues area on thigh could make it harder to sleep
More expensive due to only being recommended on internals

Is that more or less accurate?

I agree w/ the above

I'll add something about the sleep:

I'm doing internal femurs now (about 5cm so far) and am getting knee pain waking me up a few times a night. I'm experimenting with various pillow/blanket positions etc to force the knees to be bent to prevent the knee pain/knee tightness that wakes me up. Any LL veteran out there has any tips for this?

I have found that a big pillow under the knee helps somewhat but doesn't remove completely the instances of being woken up by knee pain. I'm experimenting with other positions like lying on back, knees bent, heavy-ish blanket on the feet and other pillows on the side to hold the legs in place in a knees bent position. Also tried putting feet (with knees bent) on my travel roller bag on a pillow which helped at first then I woke up with left knee pain

So I believe (not sure if this is true) that the quads tightening during sleep may contribute to the knee pain and it is good to keep the legs in a knees bent position to decrease this knee pain. I know the nurses often say to put something under your lower leg for circulation but if knee pain is keeping someone awake at night..


"Higher risk of fibula and tibias not aligned completely"

I think Dr. Asssayag also made a list of some other complications that are also more common in tibias but I can't seem to find his post

[SpeedDialer]

I've heard that compartment syndrome is more common in tibias than femurs but am not sure if this is true / what the reason might be

Anyone understand how compartment syndrome works?

[RealLostSoul]

I agree w/ the above

I'll add something about the sleep:

I'm doing internal femurs now (about 5cm so far) and am getting knee pain waking me up a few times a night. I'm experimenting with various pillow/blanket positions etc to force the knees to be bent to prevent the knee pain/knee tightness that wakes me up. Any LL veteran out there has any tips for this?

I have found that a big pillow under the knee helps somewhat but doesn't remove completely the instances of being woken up by knee pain. I'm experimenting with other positions like lying on back, knees bent, heavy-ish blanket on the feet and other pillows on the side to hold the legs in place in a knees bent position. Also tried putting feet (with knees bent) on my travel roller bag on a pillow which helped at first then I woke up with left knee pain

So I believe (not sure if this is true) that the quads tightening during sleep may contribute to the knee pain and it is good to keep the legs in a knees bent position to decrease this knee pain. I know the nurses often say to put something under your lower leg for circulation but if knee pain is keeping someone awake at night..

Had knee pain for a few days at around 4cm too. If it’s like mine it comes from the quads being too tight and pulling on it’s insertion. Only solution is to stretch more. And stretch hard. Especially before you sleep and after clicking. It will disappear after some time entirely though if you do it.


For OP list is more or less accurate. Risks with alignment and nonunion and nerve damage is much higher in tibia. Also the surgery is tougher and longer and the fibula can make problems.
Pros: it’s much smoother At least until like 5 or 6cm. And walking is much better and quicker off crutches if you choose a weightbearing nail.

[Medium Drink Of Water]

I've heard that compartment syndrome is more common in tibias than femurs but am not sure if this is true / what the reason might be

Anyone understand how compartment syndrome works?

It's when there's too much blood in a muscle and the pressure gets too high.  The cause is the muscle getting maxed out in terms of what it can handle.  The small muscles of the lower leg have a lower limit to what they can handle.  This is why you can see even huge bodybuilders with small calves.

[RealLostSoul]

It's when there's too much blood in a muscle and the pressure gets too high.  The cause is the muscle getting maxed out in terms of what it can handle.  The small muscles of the lower leg have a lower limit to what they can handle.  This is why you can see even huge bodybuilders with small calves.

Yes. The consequence of compartment syndrome is extreme pain and fasciotomy (very big ugly scar) or if left untreated necrotic leg and amputation. Basically never happens in femur.

[Medium Drink Of Water]

The size and ugliness of the scar depends on the severity of the compartment syndrome.  I tried to take a picture of my fasciotomy scars just now and they don't  even show up because of the flash.  They're 2.5 inch straight white lines down the tibialis anterior muscles and have not had any plastic surgery.

[SpeedDialer]

It's when there's too much blood in a muscle and the pressure gets too high.  The cause is the muscle getting maxed out in terms of what it can handle.  The small muscles of the lower leg have a lower limit to what they can handle.  This is why you can see even huge bodybuilders with small calves.

ty!!! Are there any mistakes some patients make that increase the chance of compartment syndrome happening? 'handle' like too much stretching or too much exercise or something?

[kamaruusman]

You missed the most important pro for tibia and con for femur:

Long tibias will always look better and natural compared to long femurs.

[RealLostSoul]

The size and ugliness of the scar depends on the severity of the compartment syndrome.  I tried to take a picture of my fasciotomy scars just now and they don't  even show up because of the flash.  They're 2.5 inch straight white lines down the tibialis anterior muscles and have not had any plastic surgery.

You probably refer to the prophylactic fasciotomy. Every responsible doctor does an inch incision to preemptively vent the muscles to avoid this with tibia LL. This is one of the reasons  why calves do get thicker with tibia ll. If you like a masculine strong look it’s positive, if you like a skinny look it’s negative. But Becker told me the leg optically slims down if you lengthen it so idk. I would not like that calf hypertrophy tbh. 

ty!!! Are there any mistakes some patients make that increase the chance of compartment syndrome happening? 'handle' like too much stretching or too much exercise or something?

No nothing to do with that. It’s comparable to fat embolism as in that happens in the beginning when you are in the hospital and it’s not patients fault. Perhaps the more precise and less invasive the surgery the better. Blood drainage helps prevents it. Prophylactic fasciotomy helps prevent it.

For the legs I have the feeling they want to be stretched all the time. If you stretch 12h a day which is impossible it would be theoretically great for the lengthening (at my stage, the tightness starts at about 2.5-3cm for femurs). So can’t overdo stretching and can’t overdo exercise (well considering you do normal stuff like walking and biking and swimming and not stupid   like running or jumping or weightlifting)

[RealLostSoul]

You missed the most important pro for tibia and con for femur:

Long tibias will always look better and natural compared to long femurs.

I do agree with that aesthetically it looks better. However, 2 important things to consider:
1) Long tibias with short femurs are impossible to hide and easier to spot as something being off.
 8cm in femur is basically “hideable” for everyone except women who wear tight strips or bikini maybe at the beach. For males; normal underwear hides it. Short pants hide it 100%. Long pants hide it very well unless maybe super skinny pants (?) i will try that out later.

2) Wearing higher shoes is impossible. Solely for that reason I wouldn’t start with tibia, lengthen less than femur and then still be unhappy because I am just like with elevator boots before, yet I can’t wear them bc I would look like on stilts.

[Medium Drink Of Water]

Every responsible doctor does an inch incision to preemptively vent the muscles to avoid this with tibia LL.

Do you have a source on that?  Whenever I hear "every responsible doctor does x" it's usually false.

[RealLostSoul]

Do you have a source on that?  Whenever I hear "every responsible doctor does x" it's usually false.

What kind of source do you want me to share? I know Paley does it because I once asked him in person about scars. Betz also said it is necessary and that they try to keep the cut smaller in women (to try to minimize permanent muscle widening). You can ask the doctors if you want.

Here is a source about it in general; http://www.scielo.org.co/scielo.php?pid=S2011-75822011000200006&script=sci_abstract
Tibia LL generally has a high risk for compartment syndrome.

[kamaruusman]

I do agree with that aesthetically it looks better. However, 2 important things to consider:
1) Long tibias with short femurs are impossible to hide and easier to spot as something being off.
 8cm in femur is basically “hideable” for everyone except women who wear tight strips or bikini maybe at the beach. For males; normal underwear hides it. Short pants hide it 100%. Long pants hide it very well unless maybe super skinny pants (?) i will try that out later.

If it looks better, then it looks better. There's no reason to hide it.

2) Wearing higher shoes is impossible. Solely for that reason I wouldn’t start with tibia, lengthen less than femur and then still be unhappy because I am just like with elevator boots before, yet I can’t wear them bc I would look like on stilts.

We shouldn't be wearing elevator shoes in the first place. We never know when we need to run or do physically demanding tasks. There are non-elevator shoes like Nike Air Max that give about 1.5" boost. That's probably the highest we can wear without losing much functions or sacrificing comfort.

[Medium Drink Of Water]

What kind of source do you want me to share? I know Paley does it because I once asked him in person about scars. Betz also said it is necessary and that they try to keep the cut smaller in women (to try to minimize permanent muscle widening). You can ask the doctors if you want.

Here is a source about it in general; http://www.scielo.org.co/scielo.php?pid=S2011-75822011000200006&script=sci_abstract
Tibia LL generally has a high risk for compartment syndrome.

I'm sure it exists, but that's a sweeping generalization and condemnation you made without anything to back it up other than talking to two doctors, who I'm sure didn't use that terminology.

[RealLostSoul]

If it looks better, then it looks better. There's no reason to hide it.

We shouldn't be wearing elevator shoes in the first place. We never know when we need to run or do physically demanding tasks. There are non-elevator shoes like Nike Air Max that give about 1.5" boost. That's probably the highest we can wear without losing much functions or sacrificing comfort.

Long tibias look better. But long tibias with short femurs look bad. That looks comical like stilts.

Well I have been doing the most physical tasks with up to 2 inch insoles , so no I totally disagree with that argument. It never hindered me.

I'm sure it exists, but that's a sweeping generalization and condemnation you made without anything to back it up other than talking to two doctors, who I'm sure didn't use that terminology.

Go out and ask them yourself. That‘s pretty standard for tibia LL, let me rephrase that; I haven’t heard of somebody who hasn’t had it done in one shape or form.
And yes they did explain the reason behind it lol.

[Medium Drink Of Water]

It's up to the person talking out his ass to prove what he's saying, not to everyone else to disprove it.

[RealLostSoul]

It's up to the person talking out his ass to prove what he's saying, not to everyone else to disprove it.

With all due respect bro I don‘t really care if you believe it or not. That‘s not my issue. I know what I have been told and learned and that‘s it. If you feel the need to proof it ask a doctor yourself. I am not going to message them to repeat what they said in text form just to “proof” for some stranger person on a forum.
I could literally take any information out of the echo chamber and questioned it without anyone being able to really finitely proof it

[SpeedDialer]

deleted post