Add 2-3 cm to the femurs with a trauma nail

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Quote from: Body Builder on December 07, 2022, 09:11:53 PM
What is wrong? The initial trauma is about 2-3 mm. At max you can take 5-6mm at once and don't risk non union.
If the amounts you mentioned were real and you could take 0.8mm at once with no problem then doctors would fix discrepancies of 1cm with just one surgery and trauma nail. But they don"t because non union is almost sure for 0.8mm and more.

Of course you can have preconsolidation at 3cm if you lengthen too slow.
But you can't lengthen 3cm at once because you will just have a bone gap forever. Thats what the user Hatch asked, how much you can add at once with a TRAUMA nail and not an LL nail. The preconsolidation that can happen is irrelevant because the initial bone gap after surgery is usually about 2-3mm and less than 0,5cm most of the times. 0,7mm will lead to very slow healing and even non union some times. But the problem is not if you can add 0,5 ore 0,7cm at once but 2-3 cm.

Anyways, to answer clearly you can't add 2-3cm at once. The max you can take without risk is 0,5cm and thats to fix only mild discrepancies, not for cosmetic LL. In my case I have about 0.3mm initial gap, I lengthened at a rate of 0,7mm per day as average and never had a problem with preconsolidation.

Definitely agree that adding height for cosmetic reasons with trauma nail is not an option. But I think you are talking about tibia, I am talking about femur. For tibia your numbers may be right. But I was told by a local orthopedic surgeon at my home that they fix discrepancies up to 2-3 cm with trauma nail only and no lengthening. By having 2cm initial gap that fuses. I was surprised too but it makes sense given most femur patients I spoke too have 0.5cm initial gap, some even up to 0.8cm

And if you say exactly 0.7+ lead to nonunion, which I believe you for tibia, I think a source to back that up would be nice. 

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Quote from: RealLostSoul on December 07, 2022, 10:16:59 PMDefinitely agree that adding height for cosmetic reasons with trauma nail is not an option. But I think you are talking about tibia, I am talking about femur. For tibia your numbers may be right. But I was told by a local orthopedic surgeon at my home that they fix discrepancies up to 2-3 cm with trauma nail only and no lengthening. By having 2cm initial gap that fuses. I was surprised too but it makes sense given most femur patients I spoke too have 0.5cm initial gap, some even up to 0.8cm

And if you say exactly 0.7+ lead to nonunion, which I believe you for tibia, I think a source to back that up would be nice.

I am sure that 2cm will for sure lead to non union even in femur too.
Maybe 0.7cm are ok for femurs but still 2cm are way too much.
Many LLers had non unions or very slow comsolidation without even big gaps to begin with (like Unicorn) so 2cm I believe is almost.impossible to not lead to a non union.
After all if it was that simple to fix a discrepancy of up to 2cm (which are tha vast majority of discrepancies) once with just a trauma nail then most of the people would have fixed it.
But for more than 1 cm all the cases I knew used some kind of an LL device to fix it.

So I still believe that  gaining2-3 cm with a trauma nail is impossible.
After all the tendons and the ligaments can't stand a so immediate lengthening and would too cause problems.

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Quote from: Body Builder on December 07, 2022, 10:58:52 PMI am sure that 2cm will for sure lead to non union even in femur too.
Maybe 0.7cm are ok for femurs but still 2cm are way too much.
Many LLers had non unions or very slow comsolidation without even big gaps to begin with (like Unicorn) so 2cm I believe is almost.impossible to not lead to a non union.
After all if it was that simple to fix a discrepancy of up to 2cm (which are tha vast majority of discrepancies) once with just a trauma nail then most of the people would have fixed it.
But for more than 1 cm all the cases I knew used some kind of an LL device to fix it.

So I still believe that  gaining2-3 cm with a trauma nail is impossible.
After all the tendons and the ligaments can't stand a so immediate lengthening and would too cause problems.

But Unicorn didn’t have issues because of that. She was forcefully lengthened 1.5mm/day, had extra fractures in one leg (perhaps because of Guichet’s osteotomy strategu) because of that this leg was instable which lead to the nail “running away” aka extending uncontrollably of it’s maximum of 10cm.

I think it’s more important to not exceed 1mm/day in femur also for nerve related issues.

Up to almost 1cm discrepancy is asymptomatic in most people, so I don’t think “everyone would have fixed theirs”. Also inserting a trauma nail is already a big invasive surgery tbh.