Topic: Which internal nail do you like best? (Read 15716 times)

KiloKAHN · « **on:** September 21, 2014, 06:28:20 AM »

Lots of internal lengthening devices to choose from. Which sounds best to you?

GROWtalORdieTRYING1 · « **Reply #1 on:** September 21, 2014, 11:05:09 AM »

I hate them all because they are too expensive. they are all deliberate rip offs.

iskd is cheap but unreliable.

I hope they could make a 10-15K internal nail that is not weight bearing. like the iskd but does not fk up.

I know its much better to weight bear, however if you had to choose between weight bearing and the price tag it would be a decent trade off for femurs.

Medium Drink Of Water · « **Reply #2 on:** September 21, 2014, 01:17:23 PM »

I said Precise because it sounds easy to use and isn't one of the "twist and shout" nails, as Dr. Birkhotlz humorously put it.

Impromptu · « **Reply #3 on:** September 21, 2014, 02:27:27 PM »

I personally lengthened with ISKD doing tibias for 6cm. Have just entered consolidation phase.

I have read online about many problems with the ISKD (especially being unreliable, distraction too fast or too slow, and other problems etc). but personally I have not experienced any of that. My entire lengthening has been smooth and the rate was almost always consistent. I guess maybe I might be one of the lucky ones. There was hardly any pain during distraction too and scarring was very minimal. But as for whether is the best nail, probably not. I don't know, will never get to try any others. But I'll just state my two cents and experiences with the one I've used.

Cheers

TRS · « **Reply #4 on:** September 21, 2014, 02:40:15 PM »

Quote from: Impromptu on September 21, 2014, 02:27:27 PM

I personally lengthened with ISKD doing tibias for 6cm. Have just entered consolidation phase.

I have read online about many problems with the ISKD (especially being unreliable, distraction too fast or too slow, and other problems etc). but personally I have not experienced any of that. My entire lengthening has been smooth and the rate was almost always consistent. I guess maybe I might be one of the lucky ones. There was hardly any pain during distraction too and scarring was very minimal. But as for whether is the best nail, probably not. I don't know, will never get to try any others. But I'll just state my two cents and experiences with the one I've used.

Cheers

Awesome! Who did you have surgery with?

I chose PRECICE2 because of the non-ratcheting mechanism. The ratcheting nails look very painful and I don't know whether there is much difference between the monorails and the ratcheting nails in terms of pain. I believe you have to click 20 times to get 1mm right? Thats too much twisting and shouting

Wouldn't the twisting actually disrupt the bone formation by delaying it?
But atleast you can safely weightbear with the internal ratcheting nail without having a external frame and Dr.Guichet's patients seem to have very good recovery, judging from the diaries. Personally I would be reluctant to go with the Betz nail due to the questionable weight bearing capability and the reported complications.
I see that Jamal nail and the albizzia nail is not in the list but they may come under the Bliskunov nail and the Gnail/Betzbone respectively.

GROWtalORdieTRYING1 · « **Reply #5 on:** September 21, 2014, 04:14:30 PM »

Quote

I personally lengthened with ISKD doing tibias for 6cm. Have just entered consolidation phase.

I have read online about many problems with the ISKD (especially being unreliable, distraction too fast or too slow, and other problems etc). but personally I have not experienced any of that. My entire lengthening has been smooth and the rate was almost always consistent. I guess maybe I might be one of the lucky ones. There was hardly any pain during distraction too and scarring was very minimal. But as for whether is the best nail, probably not. I don't know, will never get to try any others. But I'll just state my two cents and experiences with the one I've used.

Cheers

have you thought about writing a diary. as in like a 1 page summery on your experience.

also how much did your iskd cost and where did you get it done. with which doctor?

I had a feeling iskd could be done successfully.

Cannibal · « **Reply #6 on:** September 21, 2014, 04:35:51 PM »

Quote from: GROWtalORdieTRYING1 on September 21, 2014, 11:05:09 AM

I hate them all because they are too expensive. they are all deliberate rip offs.

iskd is cheap but unreliable.

I hope they could make a 10-15K internal nail that is not weight bearing. like the iskd but does not f**k up.

I know its much better to weight bear, however if you had to choose between weight bearing and the price tag it would be a decent trade off for femurs.

This article seems to imply that the success rate of Precice isn't all that much better than ISKD. They say the reliability of it it comparable and that it has a lot of problems with femur lengthening because of the ERC device.

http://www.ncbi.nlm.nih.gov/pubmed/24758320

Impromptu · « **Reply #7 on:** September 21, 2014, 05:25:05 PM »

I don't think ISKD is cheap at all. But right from the start I already had decided on my doctor and he was confident in using ISKD. (basically, I didn't really had any other choice unless I wanted to go overseas and I really wanted to lengthen in the comfort of my own country) Therefore, I did not really bother checking out the prices of any other nails as I didn't have much choice anyway. But the ISKDs are not cheap, costing about 20-25K USD at least for both legs. Then again, I don't know how much those PRECICE nails cost.

Anyway I did the operation after the last recall. So perhaps it was improved or had it's previous flaws fixed. I don't know. It worked perfectly fine for me though I admit I was quite worried about device failures or other rate problems as reported online. About the pain, I mentioned that there is hardly any pain. The ratcheting and twisting motion does seem painful but it is actually not very. Occasionally it stings a little but the pain is never great enough for it to be a factor. About the recovery and how the bone is affected by the twisting motion, I have no idea. I cannot comment because I am still consolidating.

I do not wish to openly reveal the identity of my doctor (however if you really want to know you can pm me). But basically he is not really known on forums and stuff anyway. I'm in Asia so unless you want to come to Asia for LL then only perhaps you might be interested.

Taller · « **Reply #8 on:** September 21, 2014, 06:11:30 PM »

How much did your procedure cost in total? This forum has been very interested in finding ways to cheaply and safely lengthen the femurs.

Impromptu · « **Reply #9 on:** September 21, 2014, 06:31:58 PM »

Oh crap! I didn't see the title that it was for femurs. $:-\$ sorry

My procedure for ISKD cost me about about 60-70K USD if I remember correctly.

GROWtalORdieTRYING1 · « **Reply #10 on:** September 21, 2014, 07:07:12 PM »

Quote

This article seems to imply that the success rate of Precice isn't all that much better than ISKD. They say the reliability of it it comparable and that it has a lot of problems with femur lengthening because of the ERC device.

http://www.ncbi.nlm.nih.gov/pubmed/24758320

very good article cannibal

Polycrates. · « **Reply #11 on:** September 22, 2014, 12:27:14 AM »

Would Parihar consider surgery with the ISKD, and if so, for how much? I know you said he was investigating cheaper alternatives to the Precice and it does sound promising. Maybe he could invite Dr. Sarin to Mumbai to demonstrate his nail to him.

KiloKAHN · « **Reply #12 on:** September 22, 2014, 12:43:48 AM »

Quote from: Polycrates. on September 22, 2014, 12:27:14 AM

Would Parihar consider surgery with the ISKD, and if so, for how much? I know you said he was investigating cheaper alternatives to the Precice and it does sound promising. Maybe he could invite Dr. Sarin to Mumbai to demonstrate his nail to him.

He doesn't like the ISKD due to all the problems it's known for and said he wouldn't use it even if it was available. I know he's familiar with the Bliskunov nail and he said he'd talk to Dr Guichet about his nail the next time he sees him (which I'm assuming would have been at the ASAMI conference that just happened). I'll bring it up to him again on Thursday and see if he has any new thoughts about it.

Taller · « **Reply #13 on:** September 22, 2014, 01:34:53 AM »

Quote from: KiloKAHN on September 22, 2014, 12:43:48 AM

He doesn't like the ISKD due to all the problems it's known for and said he wouldn't use it even if it was available. I know he's familiar with the Bliskunov nail and he said he'd talk to Dr Guichet about his nail the next time he sees him (which I'm assuming would have been at the ASAMI conference that just happened). I'll bring it up to him again on Thursday and see if he has any new thoughts about it.

That would be amazing. I would be very interested in lengthening with one of these nails if they indeed became available through Dr. Parihar or another competent and caring Indian doctor. The price of $30000 for precise nails alone (excluding surgery and aftercare) is just way too high for a nail that is non-weight bearing (I am ~75kG) and has a very dodgy reliability reputation.

GPS · « **Reply #14 on:** September 22, 2014, 05:10:35 AM »

Precice is not unreliable at the hands of a doctor who is well qualified to use it.
Ease of use, reverse mode, and no accidental clicks of precice makes it well superior to Gnail. Twisting of the leg is damaging to the newly formed callus and is painful. You may need to go under anesthesia to click or even rebreak your callus.

Weight bearing of Gnail is an unproven sales pitch. Precice is the only FDA approved nail and they can not make bogus weight bearing claims. You don't see Leechlet walking unaided before consolidation. He also had problems due to Dr. G's bad technique. Dr. G's awesomeness is overall a farce.

You can weight bear on precice with crutches like every other nail if you don't want to break it.

Gichelu · « **Reply #15 on:** September 22, 2014, 05:20:22 AM »

What's Bliskunov and who does it?

Taller · « **Reply #16 on:** September 22, 2014, 05:22:23 AM »

Quote from: GPS on September 22, 2014, 05:10:35 AM

Precice is not unreliable at the hands of a doctor who is well qualified to use it.
Ease of use, reverse mode, and no accidental clicks of precice makes it well superior to Gnail. Twisting of the leg is damaging to the newly formed callus and is painful. You may need to go under anesthesia to click or even rebreak your callus.

Weight bearing of Gnail is an unproven sales pitch. Precice is the only FDA approved nail and they can not make bogus weight bearing claims. You don't see Leechlet walking unaided before consolidation. He also had problems due to Dr. G's bad technique. Dr. G's awesomeness is overall a farce.

You can weight bear on precice with crutches like every other nail if you don't want to break it.

Sorry, but I've never heard of a G-nail breaking. I've heard of plenty of precise nails breaking though.

Are you claiming that Dr. Paley, Dr. Donghoon Lee, Dr. Franz Birkholtz, and many other non-cosmetic LL doctors unqualified to use Precise? If so, then your credibility has taken a huge hit in my book. The surgeons I mentioned by name are among the most qualified in the world to use Precise, and yet all of them have experienced issues with Precise nails malfunctioning and acting unreliably.

Given its track record, Precise seems like a bad deal and a gamble in my book. The problem is that there is no better deal for internal nails other than the Bliskunov/Jamal nail, and patients who used that have had quite a few consolidation issues in the past.

I've never heard of the G-nail causing problems with consolidation due to the ratcheting. In theory it may cause worse regeneration that a Precise nail, but since the bodies of patients are so unique and individual in their healing capacities anyways, the difference between the two due to ratcheting is negligible at worst.

From what I've seen, the risk of non-union from a ratcheting nail is much, much smaller than the risk of non-lengthening with a Precise nail.

I'll admit that the reverse telescoping capabilities of Precise are very nice, but if one lengthens carefully, and pays great attention to proportions and muscle tightness while lengthening, then this function shouldn't even be necessary.

If we could get the G-nail (or somehow the old Albizzia or Jamal nail) in the hands of a qualified and caring Indian doctor, it would be a dream come true for me.

Medium Drink Of Water · « **Reply #17 on:** September 22, 2014, 02:28:47 PM »

Quote from: Gichelu on September 22, 2014, 05:20:22 AM

What's Bliskunov and who does it?

It's the nail Dr. Dragan (Dr. Jamal's mentor) used. It's been replaced by the similar Jamal Nail.

TRS · « **Reply #18 on:** September 23, 2014, 10:52:05 PM »

Quote from: KiloKAHN on September 22, 2014, 12:43:48 AM

He doesn't like the ISKD due to all the problems it's known for and said he wouldn't use it even if it was available. I know he's familiar with the Bliskunov nail and he said he'd talk to Dr Guichet about his nail the next time he sees him (which I'm assuming would have been at the ASAMI conference that just happened). I'll bring it up to him again on Thursday and see if he has any new thoughts about it.

Wow! This is great

. It would be a huge step if Dr.Parihar gets the right to the Guichet nail. This would mean the Gnail will be offered at a reasonable price. I don't think Dr.Guichet will hesitate since Dr.Parihar is a a senior LL surgeon with sound knowledge in distraction osteogenesis.
Keep us updated on this.

GPS · « **Reply #19 on:** September 24, 2014, 02:03:44 AM »

Quote from: Taller on September 22, 2014, 05:22:23 AM

Sorry, but I've never heard of a G-nail breaking. I've heard of plenty of precise nails breaking though.

Are you claiming that Dr. Paley, Dr. Donghoon Lee, Dr. Franz Birkholtz, and many other non-cosmetic LL doctors unqualified to use Precise? If so, then your credibility has taken a huge hit in my book. The surgeons I mentioned by name are among the most qualified in the world to use Precise, and yet all of them have experienced issues with Precise nails malfunctioning and acting unreliably.

Given its track record, Precise seems like a bad deal and a gamble in my book. The problem is that there is no better deal for internal nails other than the Bliskunov/Jamal nail, and patients who used that have had quite a few consolidation issues in the past.

I've never heard of the G-nail causing problems with consolidation due to the ratcheting. In theory it may cause worse regeneration that a Precise nail, but since the bodies of patients are so unique and individual in their healing capacities anyways, the difference between the two due to ratcheting is negligible at worst.

From what I've seen, the risk of non-union from a ratcheting nail is much, much smaller than the risk of non-lengthening with a Precise nail.

I'll admit that the reverse telescoping capabilities of Precise are very nice, but if one lengthens carefully, and pays great attention to proportions and muscle tightness while lengthening, then this function shouldn't even be necessary.

If we could get the G-nail (or somehow the old Albizzia or Jamal nail) in the hands of a qualified and caring Indian doctor, it would be a dream come true for me.

You’re not important to determine my credibility.

How many Guichet patients do you know that you conclude his patients don’t have complications? Just because a patient of his makes videos of himself doesn’t mean other doctor’s patients cannot make videos of themselves prancing around 6 months post-OP.

You’re trying to say painful twisting of the callus is better?

Paley has not reported any malfunctioned nail, and he says in the case that patient broke his nail was because he started doing heavy activities and ignores the weight limit. When did I say it’s full weight bearing? Are you saying it randomly breaks even when normal weighing patients properly distribute their weight on crutches?

Dr. Lee’s patients were said to have pre-consolidation.

We haven’t heard any issues from Mahboubian’s, Rozbruch’s patients, or other US doctors using Precice.

Birkholtz? He has very few experiences with Precice and coincidentally his first patient ended up with a nonfunctioning nail that was unheard of before. How come a nail cannot work at all right after the surgery if he didn’t mess it up during the surgery and tested the nail? Let’s hear from Ellipse.

Taller · « **Reply #20 on:** September 24, 2014, 04:16:05 AM »

Sorry, but none of your responses except for the one regardig Dr. Birkholtz, and the corny one about credibility, served to rebuttal my points directly.

Are you calling Dr. Lee and Dr. Birkholtz unqualified by saying that Precise will not have issues if used with a qualified doctor?

Are you affiliated with Ellipse, the user known as "Stadiometer", or Precise in any way?

You're assuming causation from correlation, the oldest mistake in the book. You say that because Dr. Birkholtz is inexperienced with Precise (which is actually an untrue statement), his patient's nail failed. Actually you can't prove that that was the cause of the failure. The two variables are merely correlated in this single example.

^owned.

I don't see why you react so harshly (calling me unimportant lol) to me sharing my opinion on why I feel that precise isn't reliable.
Anyways, if you do choose to lengthen with Precise, please share a diary of your experience. Have a great day.

ShortyMcShort · « **Reply #21 on:** September 24, 2014, 04:09:49 PM »

So remind me again why Dr Guichet would approve his Gnail to be used elsewhere for cheaper? Wouldnt that just drive away patients since they can go get the exact same nail elsewhere for much cheaper...? Or am I missing something here, Im sure Dr Guichet is nice but cmon, he's not that nice

TRS · « **Reply #22 on:** September 24, 2014, 04:42:03 PM »

Quote from: ShortyMcShort on September 24, 2014, 04:09:49 PM

So remind me again why Dr Guichet would approve his Gnail to be used elsewhere for cheaper? Wouldnt that just drive away patients since they can go get the exact same nail elsewhere for much cheaper...? Or am I missing something here, Im sure Dr Guichet is nice but cmon, he's not that nice

Well lets hope he is nice and approves the use of Gnail in India

But as far as I remember, Dr.Betz did mention that Dr.Guichet sold his nail to India? He didn't specify which nail but I presume it to be the Albizzia nail.
If that's the case then it will be interesting to know which Indian surgeon uses it.

GROWtalORdieTRYING1 · « **Reply #23 on:** September 24, 2014, 04:56:31 PM »

someone should send guitch an email asking him out of curiosity if anyone in india has bought permission to use his nail and which nail. and if so which doctor.

Polycrates. · « **Reply #24 on:** September 24, 2014, 06:31:36 PM »

It would be nice, but I highly doubt Guichet would authorize the use of his proprietary nail in a country where the overall cost will be far less, as he must realize doing so would take away a lot of his own business.

Taller · « **Reply #25 on:** September 24, 2014, 07:24:49 PM »

Maybe he would authorize his old Albizzia nail instead of the newer G-nail. The Albizzia is still a very fine nail, and is far stronger than any of the competition besides the G-nail.

The only con is that it isn't reversible and can sometimes be a pain to click from what I've heard.

KiloKAHN · « **Reply #26 on:** September 25, 2014, 06:15:31 PM »

So Dr Parihar told me a bit about the recent ASAMI conference that took place in Goa. As far as internal nails go, he didn't see Guichet and didn't speak to him about his nail. However, he did see Dr Baumgart and spoke with him and some Fitbone reps about being able to use Fitbone at his hospital. Apparently they hadn't ever considered India before but they are not averse to using it so that could possibly be another internal option under Dr Parihar later.

Most interesting is that Dr Parihar spoke to a team of engineers from Finland that's currently developing a new internal nail. He was fond of the nail's specifics and he talked to the team about how manufacturing it in India is a good option. He said they seem reasonable about manufacturing costs and that it would certainly be cheaper than the current internal nails that are available elsewhere. Dr Parihar is going to send me a link about the nail later so I'll have more info about it. But for sure Dr Parihar is in the process of adding internal options in addition to the Precice.

Taller · « **Reply #27 on:** September 25, 2014, 06:26:30 PM »

I can't wait to hear more about this Finnish nail! Thanks for the info Kilokahn!

GROWtalORdieTRYING1 · « **Reply #28 on:** September 25, 2014, 07:15:36 PM »

nice work

I think that post has achieved more results than old forum has, for internal nails in india, for the last 2 years. lol

old forum will quickly fall behind this forum at this rate if its goal is to make money and not to advance safe inexpensive LL options.

Taller · « **Reply #29 on:** September 25, 2014, 08:34:30 PM »

Quote from: GROWtalORdieTRYING1 on September 25, 2014, 07:15:36 PM

old forum will quickly fall behind this forum at this rate if its goal is to make money and not to advance safe inexpensive LL options.

I think that this site is already ahead.

ShortyMcShort · « **Reply #30 on:** September 26, 2014, 06:22:07 AM »

Great news Kilo and do keep us updated about the new nail and your lengthening/recovery

Limb Lengthening Forum

Poll

If you could do femur lengthening with an internal device of your choice, which would it be?

Author Topic: Which internal nail do you like best? (Read 15716 times)

GROWtalORdieTRYING1

GROWtalORdieTRYING1

GROWtalORdieTRYING1

GROWtalORdieTRYING1

GROWtalORdieTRYING1