After years of reading and researching and even going through the surgery myself, I find one question impossible to answer.
In terms of pain, which is overall more painful, lengthening the femurs or tibias?
Asking someone who did only one segment (tibias/femurs) isn't super useful coz they didn't have the other segment done for comparison.
So it leaves those who did quadrilateral.
And then it also gets complicated because of the different methods... For example - comparing LON Femurs to Lon tibias, versus precice femurs and lon tibias..
I actually asked few guys who did quadrilateral, their opinions were
1- tibia are way easier (he did lon femur and lon tibias)
2- femurs are easier (he did precice both femurs and tibias)
3- pain was the same (he did precice both femurs and tibias)
Some of the rational for me is
1- femurs are closer to the body core so its harder to isolate the mobilization to avoid pain, like going to the toilet or any movement really.
So perhaps that's why tibia lengtheners would have some what easier.
2- femurs maybe more debilitating in the beginning but they also heal faster so maybe some time after the acute inflammation subsides, they are less painful than tibia which takes longer to heal so you're basically dealing with a fractured bone twice or 3x the duration.
3- obviously it's even harder to compare when pain is an individual experience, and also there are many variables that may or may not appear, like pin site infection which may happen but severity may vary....
So if any quadrilateral patients are reading this, I would love to get their opinion.
For me, tibia with externals was pretty hell. I don't know if it was the "normal" expected pain or something went wrong with my situation. The pin sites infection is a serious issue and i had like two weeks of extreme pain of cellulitis.
Also the tibia too commonly has foot issues with all the tendons involved in this intricate ankle/Achilles areas so a large amounts of luck and surgeons experience are required.