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[arnoldhams10]

I haven't seen that many posts that go into detail on this, however these are the two most popular options among internal nails.

It seems like an obvious decision to me when not considering money and the inconveniences associated with manual clicking vs magnetic.

All of the benefits of a weight-bearing nail (significantly faster recovery during/post-consolidation, better rehab, more self sufficiency during lengthening).

Am I missing something here? What's the catch? Some people suggest nail reversal being an issue, but non-union risk doesn't seem to be great with the femur, especially with younger patients.

[p00293]

Gnail is a bit more expensive. There's the non-union risk as mentioned, and the clicking can be painful until you get the hang of it as I know from experience.

Weigh that up against the benefits you've spoke of. I also think another benefit is you can lengthen more on gnail whereas precise stops at 8cm, although of course that isn't a benefit for everyone, only those who want to lengthen above accepted safe limits.

[uponly]

It's obvious that you haven't done CLL, or your research. Let me help you a little.

- Go to Victor's youtube channel (cyborg4life) which contains answers to probably 300% of the questions repeatedly asked on this forum. He has a video on this called Battle of the Nails with 3 world class doctors. They all talk about why Precice is superior to any nail out there.

- Here's where it becomes really obvious that you haven't done your research or CLL, because if you had, you would know that 1) this surgery is PAINFUL, and 2) clicking that many times a day becomes VERY painful. When your leg is broken, you can barely move it initially. Contorting it so it clicks 20 whatever times a day??? Absolutely not. Props to those who do it, seriously, on top of the already existing pain.

- The more important factor: weight bearing nails are stiffer and are more prone to non-union

- The ABSOLUTE MOST important factor: the ability to go in reverse. It's funny that no one thinks about this, and I've talked to multiple people where this was key to lengthening, and one whose limbs this saved. The reason why CLL exploded when STRYDE nail was released was because it had all the features of Precice AND was weight bearing, not because it was the first weight bearing nail (it wasn't).

This procedure isn't just about fully weight bearing. It's all that noobs think about, myself included, before I did 5 years of homework prior to pulling the trigger. This procedure is about having as little pain and as much comfort as possible, finishing without complications, and if you do have complications, having the ability to eliminate them so you can have a successful outcome (walking again).

[DanishViking]

Cyborg4Life recently talked about this in one of his live videoes, where he recommended to stay in the safe range between 6-7 cm on the femurs, cuz most people who do more don't fully recover or get's limited Range of motion. So the benefit of going over 8 cm is maybe an advantage for 5% of people doing this surgery, and has a laughable starting height of above 175+ cm

- 29:20

 I'm personally sticking with precice even tho it ain't weightbearing, for these reasons:

1. it's fda approved and used all over the world, which isn't the case for the other nails mentioned.

2. They have the reverse future if a non union should happen (unlikely in the femur, but still).

3. According to dr. G the pain level with doing G-nail /betzbone is about 30% higher than with precice (the surgery is already painful with precice...)

4. Precice is cheaper and according to most surgeons like mahbouhian, Dr lee, etc better...

5. the lengthening mechanism is wireless and magnetic which makes it alot easier with precice than clicking with Gnail /betzbone which can be troublesome according to many diarys on this forum.

[p00293]

Cyborg4Life recently talked about this in one of his live videoes, where he recommended to stay in the safe range between 6-7 cm on the femurs, cuz most people who do more don't fully recover or get's limited Range of motion. So the benefit of going over 8 cm is maybe an advantage for 5% of people doing this surgery, and has a laughable starting height of above 175+ cm

Nah I don't agree with this, mainly because not everyone cares about a 'full recovery'.

For instance right, so long as I can walk after surgery, climb the stairs and don't have any lingering pain, I'd consider that fully acceptable. I'd 100% make the trade of 'never playing sports again' for an extra couple of centimetres height, mainly cos I haven't played sports in about 15 years anyway. Most people only use their legs for walking and aren't interested in squatting or running marathons, and so don't need anything like '100% recovery'.

8cm and no sports/heavy leg workouts absolutely mogs 6cm and 'I can play sports and do incel lifts like squatting' for the vast majority.

[Sigma]

Nah I don't agree with this, mainly because not everyone cares about a 'full recovery'.

For instance right, so long as I can walk after surgery, climb the stairs and don't have any lingering pain, I'd consider that fully acceptable. I'd 100% make the trade of 'never playing sports again' for an extra couple of centimetres height, mainly cos I haven't played sports in about 15 years anyway. Most people only use their legs for walking and aren't interested in squatting or running marathons, and so don't need anything like '100% recovery'.

8cm and no sports/heavy leg workouts absolutely mogs 6cm and 'I can play sports and do incel lifts like squatting' for the vast majority.

I agree.

[throwaway123456]

It depends on Your Job too, I work on machinery that requires me to squat and lie and get up off the floor, I struggled with these things for  a year after CLL.

[uponly]

Nah I don't agree with this, mainly because not everyone cares about a 'full recovery'.

For instance right, so long as I can walk after surgery, climb the stairs and don't have any lingering pain, I'd consider that fully acceptable. I'd 100% make the trade of 'never playing sports again' for an extra couple of centimetres height, mainly cos I haven't played sports in about 15 years anyway. Most people only use their legs for walking and aren't interested in squatting or running marathons, and so don't need anything like '100% recovery'.

8cm and no sports/heavy leg workouts absolutely mogs 6cm and 'I can play sports and do incel lifts like squatting' for the vast majority.

Once you have the surgery you will very quickly change your mind about having a full recovery. Moreover, though, the person that cares about a full recovery and insists on it is your surgeon. The have an ethical code and a reputation to uphold. Well, most doctors anyway. Feel free to tell any prospective LL surgeon that you don't care about a full recovery and see if they'll operate on you. You'll find yourself out the door pretty quickly.

Recovering from LL isn't just about squatting, sports, etc. It's about not having chronic pain, regaining ROM, flexibility, healthy bone growth, and of course walking normally with the same or better gait. The Dr's and patient's goals should be symbiotically aligned to get you to recover with those parameters in mind. Otherwise Dr.s' wouldn't bother working with you with x rays every 3 weeks, follow-ups, protocol, PT, stretching and sleep regimen, supplements and so on. They'd just operate and leave you to your own devices.

I just took my 4th set of X-rays, have amazing bone growth, zero hardware damage, no pain when I sleep (nerve pain is gone), zero pain when I lengthen, still flexible, and am projected to make a full recovery without any complications. My PT tells me I'll be able to regain my original flexibility and ROM. All this is because I'm diligent with every single protocol prescribed by Dr. Rozbruch. And I don't want to be. I weigh 150 lbs and have the 12.5 mm rods. I could theoretically fully weight bear. I begged him to let me. He wouldn't. He told me that walking now is nowhere near as important as recovering to same as before, but being 3.2 inches taller.

That's the result you want. Don't be short-sighted in your approach. You can have both. What you want during CLL is the best Dr. possible and the best nail possible, both to get you through what will be one of the toughest times of your life with as little pain as possible, and maximizing your chances of coming out of this as close to 100% as you can. From a nail perspective, nothing comes close to Precice as of now. Supposedly a full weight bearing version of Stryde will hit the market again eventually, and I think that's when CLL will go mainstream, though it's slowly but surely gaining steam and getting there.

[p00293]

Once you have the surgery you will very quickly change your mind about having a full recovery. Moreover, though, the person that cares about a full recovery and insists on it is your surgeon. The have an ethical code and a reputation to uphold. Well, most doctors anyway. Feel free to tell any prospective LL surgeon that you don't care about a full recovery and see if they'll operate on you. You'll find yourself out the door pretty quickly.

Recovering from LL isn't just about squatting, sports, etc. It's about not having chronic pain, regaining ROM, flexibility, healthy bone growth, and of course walking normally with the same or better gait. The Dr's and patient's goals should be symbiotically aligned to get you to recover with those parameters in mind. Otherwise Dr.s' wouldn't bother working with you with x rays every 3 weeks, follow-ups, protocol, PT, stretching and sleep regimen, supplements and so on. They'd just operate and leave you to your own devices.

I just took my 4th set of X-rays, have amazing bone growth, zero hardware damage, no pain when I sleep (nerve pain is gone), zero pain when I lengthen, still flexible, and am projected to make a full recovery without any complications. My PT tells me I'll be able to regain my original flexibility and ROM. All this is because I'm diligent with every single protocol prescribed by Dr. Rozbruch. And I don't want to be. I weigh 150 lbs and have the 12.5 mm rods. I could theoretically fully weight bear. I begged him to let me. He wouldn't. He told me that walking now is nowhere near as important as recovering to same as before, but being 3.2 inches taller.

That's the result you want. Don't be short-sighted in your approach. You can have both. What you want during CLL is the best Dr. possible and the best nail possible, both to get you through what will be one of the toughest times of your life with as little pain as possible, and maximizing your chances of coming out of this as close to 100% as you can. From a nail perspective, nothing comes close to Precice as of now. Supposedly a full weight bearing version of Stryde will hit the market again eventually, and I think that's when CLL will go mainstream, though it's slowly but surely gaining steam and getting there.

Had the surgery, lengthening now so knock it off with the condescending tone.

The things you cite are exactly the same as mine (ROM and no chronic pain). You need to be able to walk, climb the stairs, and not be in pain, but that's it.

I'm quite sure many surgeons perform this surgery knowing it's unlikely the patient will be running marathons. Seems a wierd conversation to have with a surgeon but of course you're not going to bring up something like that. The fact remains, 95% of the population use their legs for walking and that's about it. No one needs to be able to do incel lifts like squats. No one needs to be able to run fast. Being taller is of much more benefit than being able to do that garbage.

Never said you shouldn't follow the doctors protocols, but you boys love your strawman arguments. Precise vs other nails could be debated till the cows come home, it's obviously not that clear cut as Precise doesn't have a monopoly on CLL nails. Non weight bearing is a huge disadvantage (and yes, the now matters every bit as much as the future, and if you're doing CLL, in the moment your experience will be much worse if you can't bear weight). The gnail/betzbone can't reverse, is more expensive, and clicking can be painful. LON tibia is cheaper but usually you'll get less height, have scars, and higher risk of complications. Pick your poison but don't act like it's a slam dunk win for any.

[uponly]

Had the surgery, lengthening now so knock it off with the condescending tone.

The things you cite are exactly the same as mine (ROM and no chronic pain). You need to be able to walk, climb the stairs, and not be in pain, but that's it.

I'm quite sure many surgeons perform this surgery knowing it's unlikely the patient will be running marathons. Seems a wierd conversation to have with a surgeon but of course you're not going to bring up something like that. The fact remains, 95% of the population use their legs for walking and that's about it. No one needs to be able to do incel lifts like squats. No one needs to be able to run fast. Being taller is of much more benefit than being able to do that garbage.

Never said you shouldn't follow the doctors protocols, but you boys love your strawman arguments. Precise vs other nails could be debated till the cows come home, it's obviously not that clear cut as Precise doesn't have a monopoly on CLL nails. Non weight bearing is a huge disadvantage (and yes, the now matters every bit as much as the future, and if you're doing CLL, in the moment your experience will be much worse if you can't bear weight). The gnail/betzbone can't reverse, is more expensive, and clicking can be painful. LON tibia is cheaper but usually you'll get less height, have scars, and higher risk of complications. Pick your poison but don't act like it's a slam dunk win for any.

It's pretty clear cut. Many doctors and experts have spoken on this, on the record. When Paley, Rozbruch, Thaller, Lee, Gdalevitch, Assayag, Mahnoubian, etc. endorse another nail, and the FDA approves one, please feel free to come back and comment.

But hey, you tell yourself whatever you want to reinforce your deluded thinking. Good luck with your recovery.

[p00293]

It's pretty clear cut. Many doctors and experts have spoken on this, on the record. When Paley, Rozbruch, Thaller, Lee, Gdalevitch, Assayag, Mahnoubian, etc. endorse another nail, and the FDA approves one, please feel free to come back and comment.

But hey, you tell yourself whatever you want to reinforce your deluded thinking. Good luck with your recovery.

Yeah I don't give a toss whether something is "FDA approved". But I don't rely on some faceless committee to tell me what's best for me, as you clearly do. Indicative of a harmless obedient cuckold who is used to being ordered around, I guess.

Of course doctors will prefer Precise because the non weight bearing doesn't impact their life at all, it's you who will have to figure out how to get to the toilet, how to get in a car, and how to live your life during lengthening in a wheelchair. The benefits of the other options come DURING the lengthening process, whereas a doctors metrics are generally judged on overall outcomes so they're not going to give that much of a crap if your life is awful using the Precise nails.

But muh FDA!

[Confidence]

Yeah I don't give a toss whether something is "FDA approved". But I don't rely on some faceless committee to tell me what's best for me, as you clearly do. Indicative of a harmless obedient cuckold who is used to being ordered around, I guess.

Of course doctors will prefer Precise because the non weight bearing doesn't impact their life at all, it's you who will have to figure out how to get to the toilet, how to get in a car, and how to live your life during lengthening in a wheelchair. The benefits of the other options come DURING the lengthening process, whereas a doctors metrics are generally judged on overall outcomes so they're not going to give that much of a crap if your life is awful using the Precise nails.

But muh FDA!

Based, but I honestly agree with you on this on the whole Precice vs weight-bearing nails argument.  Doctors will always recommend Precice because their integrity is at risk.  They don't really care if their patients have a lower quality of life during the lengthening process, and, the results that they get.  If you get 0.5cm lengthening done and walk home without complications they'd be happy because they get to pocket your money and there's no hit on their professional conscience.  They literally don't care whether or not you're in a wheelchair for months, or if you get into serious debt because you can't return to work for a long time, or if you can't get as tall as you want to be.

As a consumer you have to understand that at the end of a day it's a business.  You're going in there with your hard earned money and it's up to you to decide what you want out of it.  Benefits to the patient are clearly better with weight bearing nails (higher maximum length can be achieved 10-12cm, no wheelchair, reduced recovery time).  For me, it's a no brainer to go for the weight bearing options regardless of the fact that they're not FDA approved, more painful, and less recommended.

[oldiebuttbaddie]

OP has a good question.  Not sure why people feel the need to be condescending.  Maybe it's so that they can feel better about their decision as if it's the objectively right answer.  The truth is that it's a personal choice.  Quality of life during recovery is not something you should overlook though.  Recovery is a marathon, and if you're miserable, you're more likely to take days off.  So if not going to be able to go in reverse is going to cause someone anxiety that is important regardless of the objective risk.  Likewise, being wheelchair bound for months can get tiering to say the least.  there is no objective right answer. Only the right decision for the individual.  From my experience when people are evaluating the g-nail, they overestimate the pain of clicking but discount the very real risk of the g-nail bending.  These are things you should take into account, especially the latter. 

[p00293]

Based, but I honestly agree with you on this on the whole Precice vs weight-bearing nails argument.  Doctors will always recommend Precice because their integrity is at risk.  They don't really care if their patients have a lower quality of life during the lengthening process, and, the results that they get.  If you get 0.5cm lengthening done and walk home without complications they'd be happy because they get to pocket your money and there's no hit on their professional conscience.  They literally don't care whether or not you're in a wheelchair for months, or if you get into serious debt because you can't return to work for a long time, or if you can't get as tall as you want to be.

As a consumer you have to understand that at the end of a day it's a business.  You're going in there with your hard earned money and it's up to you to decide what you want out of it.  Benefits to the patient are clearly better with weight bearing nails (higher maximum length can be achieved 10-12cm, no wheelchair, reduced recovery time).  For me, it's a no brainer to go for the weight bearing options regardless of the fact that they're not FDA approved, more painful, and less recommended.

Agree 100%. Precise vs a weight bearing nail is a choice with pros and cons but saying 'the doctors all recommend Precise' means nothing as a doctor will be primarily concerned about their own professional reputation. If you get 4cm with Precise then give up because life in a wheelchair 24/7 is much harder, and recover after with no complications, that goes down as a successful lengthening in the doctors resume even though the patient is probably hugely disappointed with the outcome.

People need to take responsibility for their own health, and not just bow before the doctors opinion or the fking FDA or anyone else. Actually do some research and see what's best for YOU.

There's a time and place for Precise, which is probably a situation where the lengthener can count on family/partner support to help them with all the tasks they can't do in a wheelchair, they can work remotely and/or are independently rich and have no need to work, and their lengthening goals are modest. If all those are true, then sure Precise might be better. If you're going to be doing this surgery by yourself and you can't count on anyone's support, I'd always pick a weight bearing nail since life would be intolerable without it. And if you're aiming for over 8cm you have to pick one of the gnail/betzbone options since Precise only goes up to 8cm.