After reading this forum for some time, i understand that:
"All external" method has the smallest risk of fat embolism.
LATN/LON methods have less fat embolism risk than any other methods with internal nail.
Monorail method is bad because of big ugly scars.
Legthening both femurs at the same time is dangerous with any method, and almost impossible with Illizarov because of discomfort.
Things i still don't understand:
1.Will any internal method(including LON/LATN) give you permanent knee pain?? Is there a method with internal nail but without any risk of knee pain problem?
2.Are there "All External" methods except llizarov and Monorail, and are there different kinds of Ilizarov? Which Dr has the best all external Ilizarov?
3.Which is the safest method of LL(in terms of avoiding fat embolism): Both tibias, then both femurs. Or tibia+femur on first leg, and then fibia+femur on the second leg?
4.Is it possible to combine different LL methods in order to make it safer? For example, 1st surgery - All external Ilizarov on both tibia, LON on first femur. 2nd surgery - LON on the second femur?
Quote from: NewGuy1 on December 02, 2016, 07:50:35 PMAfter reading this forum for some time, i understand that:
"All external" method has the smallest risk of fat embolism.
LATN/LON methods have less fat embolism risk than any other methods with internal nail.
Monorail method is bad because of big ugly scars.
Legthening both femurs at the same time is dangerous with any method, and almost impossible with Illizarov because of discomfort.
Things i still don't understand:
1.Will any internal method(including LON/LATN) give you permanent knee pain?? Is there a method with internal nail but without any risk of knee pain problem?
Permanent knee pain mostly came from internal tibia, Internal femur should lower the risk of knee pain if they insert it from the hip side not the knee.
2.Are there "All External" methods except llizarov and Monorail, and are there different kinds of Ilizarov? Which Dr has the best all external Ilizarov?
There is no best doctor for these thing, but i would say rozbruch for externals, visit their website he will give you a great details about cleaning pins, not swimming in the beach for the first month and many many.
3.Which is the safest method of LL(in terms of avoiding fat embolism): Both tibias, then both femurs. Or tibia+femur on first leg, and then fibia+femur on the second leg?
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Fat embolism is very rare, stop thinking about it. Its like you will die during travel, be optimistic. Safest method is internal femur but it have its own risk "complication", the surgery itself is risky
4.Is it possible to combine different LL methods in order to make it safer? For example, 1st surgery - All external Ilizarov on both tibia, LON on first femur. 2nd surgery - LON on the second femur?
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If you want to be this first one and test yourself like a laboratory rat, its possible, I advice you to stick with basic surgery and don't try something new
Thanks a lot for detailed reply!
Can you also explain difference between classic Illizarov of Russian doctors and Taylor Spatial Frame(TSF)? Which one is better for just simple limb lenghthening? Does TSF give some advantages in bone alignment, complication risks, safety, saving time?
I want to do both tibias external and i dont know if I should find doctor with TSF and pay more or just go with cheap classic Illizarov...?
Internal methods are the worst methods for fat embolism.
It hardly ever happens but when it happens... it can happen even with Dr Paley. You can find some cases in old forum and other internet sites. It's quite dramatic.
Quote from: notimportant on December 06, 2016, 04:41:27 PMInternal methods are the worst methods for fat embolism.
It hardly ever happens but when it happens... it can happen even with Dr Paley. You can find some cases in old forum and other internet sites. It's quite dramatic.
First of all whoever say a about internal method thats mean he can't afford it. the surgery itself is , fat embolism is rare maybe one of 1000. Its rare as hell and when it happens its only because of two operations at the sometime, like put devices in your femur and tibia at the same time with no time difference, even if its occurred, its very easy to fix. so forget about fat embolism and think about different complication that are very common.
Quote from: NewGuy1 on December 06, 2016, 02:51:45 PMThanks a lot for detailed reply!
Can you also explain difference between classic Illizarov of Russian doctors and Taylor Spatial Frame(TSF)? Which one is better for just simple limb lenghthening? Does TSF give some advantages in bone alignment, complication risks, safety, saving time?
I want to do both tibias external and i dont know if I should find doctor with TSF and pay more or just go with cheap classic Illizarov...?
I don't know TSF or whatever, but trust me do the basic surgery and don't look for something new, I prefer to do internal if you couldn't then do external with so expert doctor, i could help you with their name, Good luck.
Quote from: The Kaiser on December 07, 2016, 04:30:07 AMI don't know TSF or whatever, but trust me do the basic surgery and don't look for something new, I prefer to do internal if you couldn't then do external with so expert doctor, i could help you with their name, Good luck.
Can you please explain what "basic surgery" means? Just classic Illizarov?
I read this and other LL-forums, and there are so many messages that classic external Illizarov frame is outdated and used only in Russia and India. All other doctors are using TSF(Taylor Spatial Frame) or other hexapod frame, which makes right bone alignment...
Quote Its rare as hell and when it happens its only because of two operations at the sometime, like put devices in your femur and tibia at the same time with no time difference,
What about two simultaneous operations on both legs TIBIAS(all external)?
So if i want to lengthen tibias and femurs on both legs, its gonna be 4 operations for every bone of every leg and will take about 2 years of time?
Quote even if its occurred, its very easy to fix. so forget about fat embolism and think about different complication
Lots of messages on many forums and just Google'ing "fat embolism" tells that fat embolism is very dangerous and hard to fix thing, which often ends dramatically... Are you sure fat embolism is not so important with LL?
Quote from: The Kaiser on December 07, 2016, 04:30:07 AMI don't know TSF or whatever, but trust me do the basic surgery and don't look for something new, I prefer to do internal if you couldn't then do external with so expert doctor, i could help you with their name, Good luck.
No offence dude but you're hardly an expert yet you give out more advice than anyone else here. Internals are a more invasive method. They just happen to be more convenient, to say they're better outright is doing a disservice to people that are here looking for real advice.
As for TSF, it's a device that allows a lot of options to correct misalignments or complications. It's not necessarily required for lengthening
As for fat embolism it's only a concern a few days after surgery. You get a shot once in the morning and you're fine.
Edit: the shot is preventive
Quote from: ub40 on December 07, 2016, 04:50:42 PMInternals are a more invasive method. They just happen to be more convenient, to say they're better outright is doing a disservice to people that are here looking for real advice.
So "all external" method is anyway safer in terms of avoiding embolism and other complications, right?
QuoteAs for TSF, it's a device that allows a lot of options to correct misalignments or complications. It's not necessarily required for lengthening
Isn't bone alignment important when you lengthening a leg? I've read something about bone anatomical/mechanical axis and that lengthening can possibly damage it, so therefore TSF is better. Or did i just misunderstood something?
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