Fat embolism

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Fat embolism syndrome is really only a risk up to 72 hours after surgery. Pulmonary embolism is slightly different and you are at greatest risk 2 weeks after the surgery, though there is an enhanced risk up to about 3 months after surgery. Every day the risk becomes less and less. Not all doctors prescribe blood thinners for the full lengthening period, particularly if the nail is weight-bearing as it is expected you are less likely to have a clot if you are moving around.

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Quote from: Body Builder on April 13, 2023, 11:55:49 PMBreaking a bone and riming it to put an internal nail in it is of course a very invasive surgery.
Externals is less invasive and by far less risky, but internal LL has many risks with the most dangerous being the one we discuss here, fat embolism. A non invasive surgery can't cause embolism nor needs anticoagulants for months.
Whatever you believe, LL is by no means a minimally invasive surgery. It is the most invasive cosmetic surgery by far and a generally invasive orthopaedic surgery.

once again my point is the way you use the term minimally invasive is not inline with its medical definition.
you percieve reaming and nailing as invasive, because you have no exposure to it other than reading about it.

you know what i shouldnt have bothered mentioning it

Quote from: thankscience on April 14, 2023, 11:35:43 AMFat embolism syndrome is really only a risk up to 72 hours after surgery. Pulmonary embolism is slightly different and you are at greatest risk 2 weeks after the surgery, though there is an enhanced risk up to about 3 months after surgery. Every day the risk becomes less and less. Not all doctors prescribe blood thinners for the full lengthening period, particularly if the nail is weight-bearing as it is expected you are less likely to have a clot if you are moving around.

this is a great statement thankscience, it should be sticked and maybe there would be less posts asking the same thing about PE and FES
 

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Quote from: Body Builder on April 13, 2023, 11:55:49 PMBreaking a bone and riming it to put an internal nail in it is of course a very invasive surgery.
Externals is less invasive and by far less risky, but internal LL has many risks with the most dangerous being the one we discuss here, fat embolism. A non invasive surgery can't cause embolism nor needs anticoagulants for months.
Whatever you believe, LL is by no means a minimally invasive surgery. It is the most invasive cosmetic surgery by far and a generally invasive orthopaedic surgery.

if you to the nuvasive site, they literally say precice is " minimally invasive"
https://www.nuvasive.com/surgical-solutions/precice-limb-lengthening-physicians/#:~:text=The%20Precice%20system%20provides%20a,Proprietary%20magnet%20technology

i feel like im failing to properly word what im trying to say:
the term minimally invasive is not spectrum, its a technique. a technique meant to reduce recovery time by decreasing the size and number of incisions. 

ok im done nitpicking 

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Quote from: oeioei2 on April 12, 2023, 11:39:04 PMYes I heard that too but I just dont understand how a fat embolism can happen after 7 weeks.
 Lets say the fact that it can still happen after 7 weeks makes me more scared to do this surgery than before I knew it.

do you have the source that says it was a fat embolism?
if you listen to the cyborg interview with dr giotkas he says pulmonary embolism
 

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Quote from: thankscience on April 14, 2023, 11:35:43 AMFat embolism syndrome is really only a risk up to 72 hours after surgery. Pulmonary embolism is slightly different and you are at greatest risk 2 weeks after the surgery, though there is an enhanced risk up to about 3 months after surgery. Every day the risk becomes less and less. Not all doctors prescribe blood thinners for the full lengthening period, particularly if the nail is weight-bearing as it is expected you are less likely to have a clot if you are moving around.

As u said, patient is at greatest risk 2 weeks after the surgery and risk up to about 3 months after surgery. I wonder many doctors don’t recommend 3 months blood thinners after surgery, maybe just 1 month blood thinners.

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Quote from: thankscience on April 14, 2023, 11:35:43 AMFat embolism syndrome is really only a risk up to 72 hours after surgery. Pulmonary embolism is slightly different and you are at greatest risk 2 weeks after the surgery, though there is an enhanced risk up to about 3 months after surgery. Every day the risk becomes less and less. Not all doctors prescribe blood thinners for the full lengthening period, particularly if the nail is weight-bearing as it is expected you are less likely to have a clot if you are moving around.

a

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Quote from: Hagane on April 14, 2023, 09:54:14 PMdo you have the source that says it was a fat embolism?
if you listen to the cyborg interview with dr giotkas he says pulmonary embolism
 

Oh I must have heard wrong then, so the embolism the Dr is talking about was the pulmonary embolism? His patient did not die from Fat embolism?
 after 7 weeks?

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Quote from: Hagane on April 14, 2023, 09:41:55 PM
if you to the nuvasive site, they literally say precice is " minimally invasive"
https://www.nuvasive.com/surgical-solutions/precice-limb-lengthening-physicians/#:~:text=The%20Precice%20system%20provides%20a,Proprietary%20magnet%20technology

i feel like im failing to properly word what im trying to say:
the term minimally invasive is not spectrum, its a technique. a technique meant to reduce recovery time by decreasing the size and number of incisions. 

ok im done nitpicking

Nuvasive wants to sell its nail and say bs as many merchants LL doctors who say that LL is almost nothing to their patients and the later end up being crippled.

Breaking a bone and puting a nail inside it is an invasive orthopaedic surgery. End of discussion. Even externals is an invasive procedure because the bone must still broke and have screws on it.
We are not talking about a boobjob here but the most invasive and hard cosmetic surgery. And only some naives who haven't done LL and maybe they will never do it think otherwise, because if they truly do it they would understand what I am saying from the first time they open their eyes after the surgery finishes. 

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Quote from: oeioei2 on April 15, 2023, 05:47:40 PMOh I must have heard wrong then, so the embolism the Dr is talking about was the pulmonary embolism? His patient did not die from Fat embolism?
 after 7 weeks?

yeah it most likey could have been from an unfortunate combination of factors.


attached is a picture of virchows triad which shows the three categories that contribute to clotting.

without knowing much about the actual details of the case , it is most likely that the cause could be from circulatory stasis and hypercoagulability, as it was 7 weeks post so there is no acute vascular injury.

its very likely that the patient was not mobilizing which caused hemostasis leading to a clot formation that dislodged and caused the PE
 

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Another thing that worries me about Dr. Giotikas is that he just openly admits the risks of dying from FE/PE as if he wouldn't be able to do much to treat it if it does happen. This conveys that he's actually not very confident about the safety of this surgery under his hands. The risk of dying according to them is 1/9000 which does seem to be quite high. In reality, the risk of dying under him is not even anywhere that low as his total osteotomy cases are probably just a couple of hundreds.

In contrast, if you ask Paley the same question, he'll just confidently tell you that you won't die under him.

By the way, I just find this thread about how you can actually prevent pulmonary embolism easily: http://www.limblengtheningforum.com/index.php?topic=66627.msg194898