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[Mondlicht]

Hey guys, which method do you think is the best for CLL? I think precise2 only internal nail is the best method for both femur and tibia.

[Hobbit99]

I went for classic ilizarov because it was the only one I could afford.
I feel like people here often forget that money is also a factor you need to take in consideration

[Sigma]

Stryde > Precice2 > LON. You are right. Precice2 is better.

[Body Builder]

Τhe safest, cheapest and most painless way for tibias, as we said many times, is externals only. By far.

[limby101]

I think only a person who did both tibia with external and tibia with internal nail could answer this.
No one can compare the experience without having gone through it.

[TheDream]

Sorry a bit off topic but is it correctly understood that:

Pure externals = no nails.
LON = lengthening over nail = purely internal methods like precise and stryde.
LATN = lengthening and then nailing = external method with nailing after lengthening.

[saltedchocolate]

lol, LON is an external fixator with an internal nail.

[limby101]

Τhe safest, cheapest and most painless way for tibias, as we said many times, is externals only. By far.

I would also love to know how you get the impression that externals are less painful than internal?

[NailedLegs]

Please read this entire thread:

http://www.limblengtheningforum.com/index.php?topic=84060.msg265525

The topic was discussed extensively. You will find a variety of arguments. You'll find a thorough answer there.

[Body Builder]

I would also love to know how you get the impression that externals are less painful than internal?

Because I did it and it was an almost fully painless experience after the first 3-4 days. I've never seen anyone with internals to say the same. Most of them are getting a lot of painkillers during their lengthening, I did't take almost anything except the first very few days and still I can't say I felt any pain at least more than 2/10.
And it is common sense that having some pins is less painful than having a big rod inside your bone.

[Mondlicht]

I don't know if i can agree with that...cheap, yes, but there are still disadvantages. Rehabilitation/exercise is difficult and  increased chance of infections. The only advantage is no internal nail. In addition, the Lon method at dr.assayag costs the same as precise2. I think a surgeon should enlighten us here...but thanks for your answer , I hope more people with precise2/lon tibia comment on their experiences here

[Hldrive]

I also got the idea that LON tibia is best, however LON femur is worse

[limby101]

Im doing external and it was pure hell for the most parts.
Pain during first two weeks was almost unbearable. Definitely 10/10.
Infections can be debilitating.
Having 2 extra surgeries to replace pins.
The loss of range of motion because of pins stuck in your joints and tendons and muscles.
No ability to move around comfortably.
Lack of sleep.
Being seen outside is a lot more tolerable with no metal cages on your legs...

I'm sure there are other experiences but thats the point, you it's an individual experience. Only someone who went through both methods can really compare them.

[Body Builder]

Im doing external and it was pure hell for the most parts.
Pain during first two weeks was almost unbearable. Definitely 10/10.
Infections can be debilitating.
Having 2 extra surgeries to replace pins.
The loss of range of motion because of pins stuck in your joints and tendons and muscles.
No ability to move around comfortably.
Lack of sleep.
Being seen outside is a lot more tolerable with no metal cages on your legs...

I'm sure there are other experiences but thats the point, you it's an individual experience. Only someone who went through both methods can really compare them.

I had only 1 minor infection during 10-11 months I had the fixators on which sunsided easily with 5.days of oral antibiotics (some of the most common ones).
What you mention about debilitating infections and all these are a result of going to rotten places like India and Turkey. I am sure that no patient of Giotikas, Pili or any other good doctor have any of these problems with pure externals (infections, broken nails etc). If your doctor is a crook then even with precise 2 or any other internal-mixed method you risk much worse infections that can lead to amputation and of.course deep vein thrombosis which is almost a no risk for externals only.

Imo for tibias pure externals with hexapofs are the best way if you can handle some big fixators for about 10 months and the only other way is precise. Lon and latn have the disadvantages of both methods and it is the worst way by far.
For femurs, internals with a magnetic nail is the only sensible way.

[Bob]

.

[limby101]

I don't agree with you.
Infections can be entirely not related to the surgeon or the center. It depends on patients and the environment. Some night get not so lucky to get an infection of a more resistant bugs to the common antibiotics because of thousands of factors you can't even predict, which can lead to a persistent infection that can lead to deep infection etc..
The surgeon should be able to treat complications like infections but other than antibiotics or pin replacement there are no magic tricks of going around this.

And about pain well I didnt have an internal rod so I can't tell how painful it is, but the first 2-3 weeks of fixators it was extremely painful. Perhaps it's individual, perhaps surgeons work, but I don't think you can say the rule is pain free for the whole process except for few first days. You got lucky so I'm happy for you but I'm sure many more suffered a great deal.
I can think only of victor from cyborg4life that had external and precice nail and his opinion is definitely easier with precice. Although his external was femurs...

I think the fracture is a main cause of pain at the beginning, afterwards the pins with all their effects on soft tissues are the cause of pain that gradually may subside or turn into chronic pain or stiffness or other limitations.
The drilling of the medullary canal and inserting a nail inside, definitely it's a trauma to the body but I can't tell anything about the pain on that scale..

[limby101]

By the way, to be 10 months with those frames is not na easy task mentally. I'm sure some or most can handle it with proper planning and especially proper mindset. But otherwise being 2-3 months with frames compared to almost a year, is a no brainer for most.
Also, the longer the frames are on, higher is the risk for infections..

About safety, perhaps the externals are safest in terms of the severeness of complications. With pure external infection is basically the only risk (although it's extremely common) but I agree it's not a major complication compared to others (misalignment, internal nail infection, bending of nail etc).

[Hobbit99]

By the way, to be 10 months with those frames is not na easy task mentally. I'm sure some or most can handle it with proper planning and especially proper mindset. But otherwise being 2-3 months with frames compared to almost a year, is a no brainer for most.
Also, the longer the frames are on, higher is the risk for infections..

About safety, perhaps the externals are safest in terms of the severeness of complications. With pure external infection is basically the only risk (although it's extremely common) but I agree it's not a major complication compared to others (misalignment, internal nail infection, bending of nail etc).

Also with pure external you can easily fix misalignments without doing another surgery

[limby101]

Speaking of safety with tibia,
I wonder what are your thoughts about this:
Pure external perhaps are the safest, but comparing LON with LATN - which is safer in your opinion?
I guess the risk of infection is the same in both, of an infection in skin spreading deeper to the bone.. but I wonder what is riskier.

[Body Builder]

Speaking of safety with tibia,
I wonder what are your thoughts about this:
Pure external perhaps are the safest, but comparing LON with LATN - which is safer in your opinion?
I guess the risk of infection is the same in both, of an infection in skin spreading deeper to the bone.. but I wonder what is riskier.

Lon is easier as you do everything in the initial surgery while on latn you need another one when you stop lengthening. The risk of deep bine infection is about the same. Generally speaking I don't think of any benefit of latn to lon, just another surgery in the middle of the ll journey.
That said I believe that both lon and latn are worst choices compared to pure external or internal.