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Posted on Jul 31, 2021, 8:11 am
#1

Hey guys,
Giotikas told me today that Precise will be back in Europe in September, but he will also start using G-nail because it's weight bearing. My first thought is to wait for Precice and, if there are more delays, do G-Nail. However, I would like to know your opinions.
More info:


https://www.athensbjr.com/introduction-of-g-guichet-nail/

https://www.athensbjr.com/methods-of-bone-fixation-in-limb-lengthening/#1586804812044-2153da5a-68a1



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Posted on Jul 31, 2021, 9:04 am
#2

This is great news. I genuinely think this is now one of the best options in the market. You get a proven weight bearing nail performed by Giotikas who will also do an ITB release. My situation worked  out great in the end but if I had this option in March I would have chosen this over going to Betz. Weight bearing is a huge advantage.

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Posted on Jul 31, 2021, 9:32 am
#3

Wasn't the issue with g nail runaway lengthening and the inability to reverse? Have these been corrected?

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Posted on Jul 31, 2021, 9:46 am
#4

Quote from: Highest on July 31, 2021, 09:32:28 AMWasn't the issue with g nail runaway lengthening and the inability to reverse? Have these been corrected?

No, it can't reverse. It's obviously a clear disadvantage, but of course, I have also to consider weight bearing instead of being months on wheelchair. I don't know what runaway lengthening is. I apologize, as English is not my main language. I'm so conflicted right now.

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Posted on Jul 31, 2021, 10:07 am
#5

runaway lengthening is when the clicks happen unintentionally and you keep lengthening even when you don't want to.

The biggest risk of Guichet nail is non-union.

If you don't want to use a wheelchair at all, you can do one leg at a time on Precice but you will need a long time to finish it.

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Posted on Jul 31, 2021, 10:13 am
#6

Quote from: Want-3-inches on July 31, 2021, 10:07:33 AMrunaway lengthening is when the clicks happen unintentionally and you keep lengthening even when you don't want to.

The biggest risk of Guichet nail is non-union.

If you don't want to use a wheelchair at all, you can do one leg at a time on Precice but you will need a long time to finish it.

But non union can be prevented by doing very regular x rays right? If there is bad bone growht, I can stop lenghtening. To be honest, my main worry is malfunction. It would be horrible to waste all this money and effort for the nail to suddenly stop working. However, Precise has also the risk of bending, so I don't reallt know what to do. I think I will wait to September for Precice and, if there are more delays, I would take G-nail. However, the weight bearing part is tempting.

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Posted on Jul 31, 2021, 10:20 am
#7

Quote from: V21 on July 31, 2021, 10:13:45 AMBut non union can be prevented by doing very regular x rays right? If there is bad bone growht, I can stop lenghtening. To be honest, my main worry is malfunction. It would be horrible to waste all this money and effort for the nail to suddenly stop working. However, Precise has also the risk of bending, so I don't reallt know what to do. I think I will wait to September for Precice and, if there are more delays, I would take G-nail. However, the weight bearing part is tempting.


If there is runaway lengthening then you can't stop. See Unicorn's diary.

Giotikas is new to the nail, so that is an extra problem.

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Posted on Jul 31, 2021, 11:39 am
#8

Quote from: Want-3-inches on July 31, 2021, 10:20:34 AMIf there is runaway lengthening then you can't stop. See Unicorn's diary.

Giotikas is new to the nail, so that is an extra problem.

I thought Unicorn's problems were because Guichet made her click too much? Regarding Giotikas being new to the nail, yeah, that's something to consider.
Anyway, would you choose Precice? I'm leaning to wait to September. After all, I just want 5.5 cm.

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Posted on Jul 31, 2021, 12:08 pm
#9

Quote from: V21 on July 31, 2021, 11:39:24 AMI thought Unicorn's problems were because Guichet made her click too much? Regarding Giotikas being new to the nail, yeah, that's something to consider.
Anyway, would you choose Precice? I'm leaning to wait to September. After all, I just want 5.5 cm.


I'm on Betzbone, which is almost identical to the Guichet nail. Both derive from the Albizzia nail.

1) Guichet uses a similar knee rotational mechanism to lengthen the nail. The rotation angle is perpendicular to your walking stance and was chosen specifically because it is not used in day-to-day activity.  It cannot "runaway." I think some people are confusing it with ISKD.

2) Not reversing would only be an issue with tibias, where malunion is much more likely to occur. Femur malunion almost never happens in healthy young adults.

3) I agree with Want-3-inches that Giotikas being new to the nail may be the biggest problem. The operational procedure and aftercare may be different. I would want to see Giotikas perform at least 5 or so procedures before trying his Guichet nail.

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Posted on Jul 31, 2021, 12:34 pm
#10

Quote from: SirStretchAlot on July 31, 2021, 12:08:22 PMI'm on Betzbone, which is almost identical to the Guichet nail. Both derive from the Albizzia nail.

1) Guichet uses a similar knee rotational mechanism to lengthen the nail. The rotation angle is perpendicular to your walking stance and was chosen specifically because it is not used in day-to-day activity.  It cannot "runaway." I think some people are confusing it with ISKD.

2) Not reversing would only be an issue with tibias, where malunion is much more likely to occur. Femur malunion almost never happens in healthy young adults.

3) I agree with Want-3-inches that Giotikas being new to the nail may be the biggest problem. The operational procedure and aftercare may be different. I would want to see Giotikas perform at least 5 or so procedures before trying his Guichet nail.

Thanks for the insight. In your research about Betzbone, would you say that there is a higher malfunctioning rate compared to Precice? To be honest, my biggest fear is investing all this money and effort for the nail just to stop working mid lengthening. Of course, with Precise there is also risk of breaking the nail.

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