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[Uppland]

My, still theoretical, operation will not happen for some years yet but the more I learn of the operation the more determined I am to minimize the risks involved.
The title question is a tricky one to answer, I imagine few on this board have done the operation more than once. Also realize quality vary greatly between doctors and individuals. Still does anyone know if this surgery is becoming easier and if so will that trend continue?

Thanks everyone.

[KiloKAHN]

Limb lengthening has definitely become more humane over the years in terms of focusing on the reduction of patient pain, and the surgery has come a long way from the beginning with the creation of six-axis correction systems and internal lengthening devices. As for the last 5 years, I'm not sure. Did Precice revolutionize limb lengthening in terms of safety? Maybe a Precice patient can way in on it.

My opinion is that there is a limit to how easy limb lengthening can get no matter what method is used, simply due to what's involved, and that how it is now is almost as good as it's going to get. At least, I can't comprehend how this will be made more tolerable in years to come.

[TRS]

Well the technology has definitely improved with the introduction of the non-racheting and reverse functioning PRECICE nail. It is more comfortable than external fixators and the other racheting internal nails. It also offers more weight bearing than the Fitbone nail. But in terms of lengthening, the complications are still the same and the rate of 1mm per day still applies.
So basically, LL is still a very risky and tedious procedure despite the introduction of the new technology in LL.

[Uppland]

Is it possible to sacrifice time in order to get a safer process?
Maybe lenghten 0.5 mm a day.

[TRS]

Is it possible to sacrifice time in order to get a safer process?
Maybe lenghten 0.5 mm a day.

It is possible. BUT you could risk premature consolidation and then the surgeon has to rebreak the bone. Premature consolidation can potentially damage the internal nail during distraction.

[Uppland]

Can the speed of regrowth be measured and a optimal "slowest distraction speed" be set for each patient?
What are the benefits of lenghtening more slowly?
What are the risks of lenghtening too fast?

[TRS]

Can the speed of regrowth be measured and a optimal "slowest distraction speed" be set for each patient?
What are the benefits of lenghtening more slowly?
What are the risks of lenghtening too fast?

The speed of the regenerate can be measured by X-rays and the optimal distraction speed is 1mm for femurs and 0.75 for tibias. But individual factors do apply. Doctors will be able to monitor your regenerate over a period and maybe able to decide the slowest distraction speed.
The benefits of lengthening slowly is less pain and less stress on the soft tissues, giving it more time to adapt to the new length.
The risks of lengthening to fast is more pain, nerve damage, early contractures, delayed union and non-union.

[endomorphisme]

We still don't know the long terms risks, so we don't know wether it's safer or not.

[Uppland]

We still don't know the long terms risks, so we don't know wether it's safer or not.

Really?
I thought this was an old procedure from the 1960's or so..

[Taller]

The limited follow up studies that exist for 1960's patients show that they lived their lives normally afterwards, in most cases.

[TRS]

Really?
I thought this was an old procedure from the 1960's or so..

Most of the long term studies have been on patients with pre-existing deformities or trauma. CLL has been a recent phenomenon and patients that undergo it are generally healthy and normal.

[programdude]

The Precice has the standard limitations, however can retract as well which is useful sometimes. While ironically I wouldn't say it is terribly Precise as me and others have had some minor discrepancy issues, I haven't heard of anything too bad from the ten or so people i've personally met.

Th actual lengthening is painless, and other than aches the pains are very tolerable overall from the precice. So I'd say its an advancement, though not a miracle breakthrough.

[Uppland]

What about differet methods what is the major differences between external and internal surgery?

[KiloKAHN]

What about different methods what is the major differences between external and internal surgery?

This may answer some of your questions and gives a summary of multiple lengthening options available.

http://www.limblengtheningforum.com/index.php?topic=95.0