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Author Topic: Does lengthening rate actually matter in terms of 'total recovery time needed'?  (Read 4075 times)

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p00293

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Just something I've been thinking about...

Let's say we have 2 guys, patient A and patient B. Both of them want to do 6cm on femurs.

Patient A lengthens at a relatively fast rate of 1.5mm a day, and is done with his lengthening in 40 days. Patient B lengthens at a slow rate of 0.75mm a day, and is thus done in 80 days.

Does that actually mean, all things equal (i.e. assuming patient A doesn't have complications from lengthening too quickly, and patient B doesn't suffer pre-consolidation from lengthening too slowly) that patient A will have a 'full recovery' 40 days faster? I'm not sure it does.

We know that bone is growing during the lengthening period, which is why we all get checkups every few weeks to see how it's going on that end. My theory is that, regardless of the rate of lengthening, the 'total time to a full recovery' is going to be about the same with these 2 patients. True, patient A starts the consolidation phase 40 days earlier, but at the 41st day, he still only has the same bone growth as patient B. From day 41-80 (i.e. A's consolidation, B's lengthening) it's true enough A will have bone growth, but surely so will B, it's just B hasn't finished lengthening yet but when he does, he'll likely have a 40 days shorter consolidation period than A, as he grew more bone during his lengthening phase whereas A grew more during the consolidation phase.

The only way this wouldn't be true, is if bone grows faster during consolidation than during lengthening. Does anyone know if that's true or not?


Because if it's not, I really see no reason to aggressively push to try and finish lengthening as early as possible. The recovery time would be around the same overall.
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lessthanavg8300

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Bro you are incredibly naive and anyone that has actually done LL will say the same.  1) nerves grow at a max of 1mm per day so youre risking injury.  2) lengthening just 1mm per day is unsustainable for the vast majority of people aside from the very beginning.  You have no idea how uncomfortable and painful this procedure is.

You really talk with a lot of confidence all over this site yet have never done LL.  You prob havent even had a consultation yet.  Please come back and inform when you have your reality check and actually go through it.
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Gained 3.2CM on femurs for a final height of 5'8.5-5'8.75.

p00293

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Bro you are incredibly naive and anyone that has actually done LL will say the same.  1) nerves grow at a max of 1mm per day so youre risking injury.  2) lengthening just 1mm per day is unsustainable for the vast majority of people aside from the very beginning.  You have no idea how uncomfortable and painful this procedure is.

You really talk with a lot of confidence all over this site yet have never done LL.  You prob havent even had a consultation yet.  Please come back and inform when you have your reality check and actually go through it.

Keep barking, I'm clearly discussing a hypothetical situation. Change the numbers to 0.375mm and 0.75mm if you wish. The question being asked is obvious, sorry you're a bit thick.
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lessthanavg8300

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lmfao, you're calling .75 a "slow rate".  You can change the numbers and walk it back if you wish....as you should.
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Gained 3.2CM on femurs for a final height of 5'8.5-5'8.75.

p00293

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lmfao, you're calling .75 a "slow rate".  You can change the numbers and walk it back if you wish....as you should.

No need to reply to any more of my threads or posts, I need someone with brains, preferably someone who actually did lengthening too, and you fail on both counts (nah, 3.2cm isn't real lengthening, all that tells me is you're a weak willed cuck who bails at the first sign of difficulty).
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lessthanavg8300

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Whatever you say short stuff.  My original goal was 4-5CM max and 3.2CM is more than youll ever do.
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Gained 3.2CM on femurs for a final height of 5'8.5-5'8.75.

p00293

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Whatever you say short stuff.  My original goal was 4-5CM max and 3.2CM is more than youll ever do.

Imagine breaking your legs for 3.2cm. You honestly should just quit the forum in disgrace.

With a mentality like yours, no doubt your wife will be having a live-in boyfriend soon.
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lessthanavg8300

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Imagine being your height and dreaming of being a 3rd wheel lmaaaoooo.  Sad life, end it.
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Gained 3.2CM on femurs for a final height of 5'8.5-5'8.75.

p00293

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Imagine being your height and dreaming of being a 3rd wheel lmaaaoooo.  Sad life, end it.

Keep barking for me dog, got a condo in your head, living rent free.

3.2cm, just lol, that's the most pathetic performance I've ever read about on here. Just read your diary, bitching and whining about clicking. Your forefathers are turning in their grave. Imagine your ancestors hunted wild boar and went to war, while their descendent can't even manage to turn his leg a few degrees.

Pathetic.
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lessthanavg8300

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Yeah, thats why you argue with everyone on the site nonstop, because youre grounded and in the heads of everyone else.  keep yapping and im going to put you in a diaper and in your crib.
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Gained 3.2CM on femurs for a final height of 5'8.5-5'8.75.

Michael J. Assayag, MD

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Stay respectful on these forums.

In a grown adult, lengthening slower will create better bone and accelerate consolidation overall.

I love lengthening at 0.75mm/day at the femur because the regenerate is absolutely thicker and better quality.
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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
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IG @bonelengthening

p00293

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Stay respectful on these forums.

In a grown adult, lengthening slower will create better bone and accelerate consolidation overall.

I love lengthening at 0.75mm/day at the femur because the regenerate is absolutely thicker and better quality.

So overall, in these two hypothetical patients, patient A will not necessarily recover quicker because he finished his lengthening quicker?

And thus really, there is absolutely no reason to try and lengthen quickly unless xrays show a significant risk of pre-consolidation?
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Fireworks196

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Imagine spending millions of euros to lengthen just 3 cm... a bad example of willpower and commitment to yourself
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Pointing to Dr.Betz/Becker or Dr.Pili

Everything is possible. You only live once..

shortisnotfun

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Just something I've been thinking about...

Let's say we have 2 guys, patient A and patient B. Both of them want to do 6cm on femurs.

Patient A lengthens at a relatively fast rate of 1.5mm a day, and is done with his lengthening in 40 days. Patient B lengthens at a slow rate of 0.75mm a day, and is thus done in 80 days.

Does that actually mean, all things equal (i.e. assuming patient A doesn't have complications from lengthening too quickly, and patient B doesn't suffer pre-consolidation from lengthening too slowly) that patient A will have a 'full recovery' 40 days faster? I'm not sure it does.

We know that bone is growing during the lengthening period, which is why we all get checkups every few weeks to see how it's going on that end. My theory is that, regardless of the rate of lengthening, the 'total time to a full recovery' is going to be about the same with these 2 patients. True, patient A starts the consolidation phase 40 days earlier, but at the 41st day, he still only has the same bone growth as patient B. From day 41-80 (i.e. A's consolidation, B's lengthening) it's true enough A will have bone growth, but surely so will B, it's just B hasn't finished lengthening yet but when he does, he'll likely have a 40 days shorter consolidation period than A, as he grew more bone during his lengthening phase whereas A grew more during the consolidation phase.

The only way this wouldn't be true, is if bone grows faster during consolidation than during lengthening. Does anyone know if that's true or not?


Because if it's not, I really see no reason to aggressively push to try and finish lengthening as early as possible. The recovery time would be around the same overall.

The real answer is that lengthening rate is individual. Some can go fast, some can go slow. We have 0.75mm/day for tibia and 1mm/day for femur because that's what most can handle.

I did 1mm/day on my tibia for around 30 days, and after that I slowed to 0.75mm/day.
Towards the end, I couldn't even handle 0.75mm/day, I had to slow down to like 0.25mm/day, because my body was telling me to chill out.

You also risk nerve injury, if you lengthen too fast, which may be impossible or atleast very difficult to recover from.

I don't regret lengthening slow, because I don't have nerve issues related to lengthening. All my toes work, I have sensation, and I can move my legs in any which way I want.
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My story of how Yuksel Yurttas crippled me:

http://www.limblengtheningforum.com/index.php?topic=85804.0

informationispower

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Imagine spending millions of euros to lengthen just 3 cm... a bad example of willpower and commitment to yourself

Imagine being on this forum for 3 years and still not knowing how much ll costs.
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p00293

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The real answer is that lengthening rate is individual. Some can go fast, some can go slow. We have 0.75mm/day for tibia and 1mm/day for femur because that's what most can handle.

I did 1mm/day on my tibia for around 30 days, and after that I slowed to 0.75mm/day.
Towards the end, I couldn't even handle 0.75mm/day, I had to slow down to like 0.25mm/day, because my body was telling me to chill out.

You also risk nerve injury, if you lengthen too fast, which may be impossible or atleast very difficult to recover from.

I don't regret lengthening slow, because I don't have nerve issues related to lengthening. All my toes work, I have sensation, and I can move my legs in any which way I want.

It's not really about the raw numbers. My question is more: is total recover time going to be the same irrespective of lengthening rate assuming there are no complications in both patients. This could apply at 1mm vs 0.5mm, or 0.8mm vs 0.4mm etc.

Because if bone growth is at the same rate whether lengthening or consolidating, it would seem lengthening slower is objectively the best option (same overall recovery time, lower chance of nerve damage, and of course, an easier time during the lengthening phase itself).
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shortisnotfun

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It's not really about the raw numbers. My question is more: is total recover time going to be the same irrespective of lengthening rate assuming there are no complications in both patients. This could apply at 1mm vs 0.5mm, or 0.8mm vs 0.4mm etc.

Because if bone growth is at the same rate whether lengthening or consolidating, it would seem lengthening slower is objectively the best option (same overall recovery time, lower chance of nerve damage, and of course, an easier time during the lengthening phase itself).

It's individual again. I had another person lengthen the same as me, at around the same start time. My bones are almost fully consolidated, his not so much.
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My story of how Yuksel Yurttas crippled me:

http://www.limblengtheningforum.com/index.php?topic=85804.0

Body Builder

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The only reason to lengthen fast is to avoid premature consolidation.
Other than that the way to go is as slow as you can because it lets your soft tissues adapt better to lengthening and be stretched easier and also the callus formation is always better and you need less time for rehabilitation.

So in the long term you gain nothing from fast lengthening but only problems. But sometimes it is the only way, especially for the first 2-3 cm and more specific in femurs, otherwise the premature.consolidation will stop you way before you reach your lengthening target.

For my personal experience the best rate for tibias are about 0,66mm per day as an average. For femurs I dom't have experience but from what I've seen with other LL'ers , 0,75-1mm are on the safe side but clearly not more than that.
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Fireworks196

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A while ago I remember reading an effective strategy here. It is to lengthen the bone by segments until reaching its goal, for example there are people who have broken their femur or tibia more than once to achieve their maximum extension capacity, an intelligent and safe methodology but more expensive.
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Fireworks196

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@informationispower lmao, the world of LL doesn't revolve around this site
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junior006

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The only reason to lengthen fast is to avoid premature consolidation.
Other than that the way to go is as slow as you can because it lets your soft tissues adapt better to lengthening and be stretched easier and also the callus formation is always better and you need less time for rehabilitation.

So in the long term you gain nothing from fast lengthening but only problems. But sometimes it is the only way, especially for the first 2-3 cm and more specific in femurs, otherwise the premature.consolidation will stop you way before you reach your lengthening target.

For my personal experience the best rate for tibias are about 0,66mm per day as an average. For femurs I dom't have experience but from what I've seen with other LL'ers , 0,75-1mm are on the safe side but clearly not more than that.
plus you can rebreak in the event of premature consolidation
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TheDream

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The tension in your soft tissue would be extremely painful from the fast lengthening.

The main enemy with LL is not the bone. The bone lengthens just fine. The enemy is the soft tissue which is the most likely reason to F you up.
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LONFemurs2021

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Imagine breaking your legs for 3.2cm. You honestly should just quit the forum in disgrace.

With a mentality like yours, no doubt your wife will be having a live-in boyfriend soon.

Your immaturity shows.
How you respond to this surgery is *highly* individual.
When I did it a literal doctor quit at 3cm because he was in unbearable pain which included nerve irritation to the point of tremors. We were lengthening at the same speed, yet I had none of the symptoms this guy had.
It *is* incredibly painful, but for some it can be categorized as unbearable pain. It's easy to act tough without having actually gone through it.
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p00293

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The only reason to lengthen fast is to avoid premature consolidation.
Other than that the way to go is as slow as you can because it lets your soft tissues adapt better to lengthening and be stretched easier and also the callus formation is always better and you need less time for rehabilitation.

So in the long term you gain nothing from fast lengthening but only problems. But sometimes it is the only way, especially for the first 2-3 cm and more specific in femurs, otherwise the premature.consolidation will stop you way before you reach your lengthening target.

For my personal experience the best rate for tibias are about 0,66mm per day as an average. For femurs I dom't have experience but from what I've seen with other LL'ers , 0,75-1mm are on the safe side but clearly not more than that.

Right so you can confirm a longer lengthening period = a shorter consolidation, all things equal?

Seems there's no good reason to ever lengthen quickly then unless it's to avoid pre-consolidation. Seems odd that some doctors try and push the patients to lengthen quickly (mainly in Turkey), and also odd that some patients try and lengthen as fast as they possibly can.

Your immaturity shows.
How you respond to this surgery is *highly* individual.
When I did it a literal doctor quit at 3cm because he was in unbearable pain which included nerve irritation to the point of tremors. We were lengthening at the same speed, yet I had none of the symptoms this guy had.
It *is* incredibly painful, but for some it can be categorized as unbearable pain. It's easy to act tough without having actually gone through it.

3.2cm is a pathetic performance and is indicative of nothing more of a weak will and no determination. Someone being a doctor doesn't mean they don't have those traits either - you can be book smart and yet still have no ability to handle adversity. It's the worst performance I've ever seen posted on here and so deserved to be called out once he started chatting sh*t.
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Growing Experience

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I wish doctors would be more open to discuss with patients and customize their distraction plan according to the callus formation.

In my case, bone growth has been quite slow and I wonder if I could have gotten better results in terms of distraction achieved and muscle recovery if I had done 0.5 - 0.75mm/day in the latter half of lengthening phase.

I knew my body was not taking it well at 1mm/day and had to stop short of 7cm!
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Bilateral Femurs (Precise 2.2) with Dr. Mangal Parihar on 2nd Aug 2022
Starting Height - 162cm ; Gained 6.9cm

Perhaps the butterfly is proof that you can go through a great deal of darkness yet still become something beautiful

p00293

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I wish doctors would be more open to discuss with patients and customize their distraction plan according to the callus formation.

In my case, bone growth has been quite slow and I wonder if I could have gotten better results in terms of distraction achieved and muscle recovery if I had done 0.5 - 0.75cm in the latter half of lengthening phase.

I knew my body was not taking it well at 1mm/day and had to stop short of 7cm!

Can't you just lengthen at a rate that you want anyway? It's only you performing the lengthening after all - there's no law that says you 'have' to follow the doctors orders to do 1mm if you don't feel like it.
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ballsackoffury123

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Wow this is a great read. I started doing 0.75mm at 30mm because of nerve pains and the nerve pains gotten better now at 45mm and I wanted to go back to 1mm/day to finish this distraction up and blow up my ERC. But I guess I’ll stick with 0.75mm/day until I hit 8.
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ballsackoffury123

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Stay respectful on these forums.

In a grown adult, lengthening slower will create better bone and accelerate consolidation overall.

I love lengthening at 0.75mm/day at the femur because the regenerate is absolutely thicker and better quality.

Welcome back to the forums doc!  I was torn between choosing you or Dr D to do my surgery.  I sorta wish I chose you but too late now..
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Body Builder

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plus you can rebreak in the event of premature consolidation
Not that easy as some people think it is, especially if you have an internal rod during lengthening. Also many doctors don't perform it if you have already lengthen more than 4-5 cm and then you have preconsolidation.
The best way is to avoid it and it can only be done by close surveillance with x rays and faster  lengthening rate when callus is becoming too strong.
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Body Builder

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Can't you just lengthen at a rate that you want anyway? It's only you performing the lengthening after all - there's no law that says you 'have' to follow the doctors orders to do 1mm if you don't feel like it.
You can always lengthen less than the safe amount, if your callus is weak or your soft tissues feel very stiff.
But never more than that.
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junior006

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Not that easy as some people think it is, especially if you have an internal rod during lengthening. Also many doctors don't perform it if you have already lengthen more than 4-5 cm and then you have preconsolidation.
The best way is to avoid it and it can only be done by close surveillance with x rays and faster  lengthening rate when callus is becoming too strong.
how often should x rays be taken? every week at least?
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