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?
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...?
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I read this and other LL-forums, and there are so many messages that classic external Illizarov frame is outdated and used only in Russia and India.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: 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?
Quote from: The Kaiser on December 07, 2016, 10:29:51 PMbut most of them prefer Internals, Guichet said it once, doing externals like riding a horse while theres car. Externals is old method
But ALL external tibias (without nails) is the best way to avoid permanent knee pain, right?
Quote from: The Kaiser on December 31, 2016, 12:39:09 AM
What i know if you want both start for internal femur first, as best doctors advice.
Is it possible to lengthen both tibias and femurs in the same time? I mean inserting nail in one femur, then in other, and while femur nails are still in, install external frames on tibias?
And will lengthening all in the same time increase risk of fat embolism or knee pain?
Quote from: The Kaiser on December 31, 2016, 12:39:09 AM
What i know if you want both start for internal femur first, as best doctors advice.
Is it possible to lengthen both tibias and femurs in the same time? I mean inserting nail in one femur, then in other, and while femur nails are still in, install external frames on tibias?
And will lengthening all in the same time increase risk of fat embolism or knee pain?
Quote from: The Kaiser on December 31, 2016, 10:58:59 PMwhat i know that their should be at least if you insist 3 months for the second surgery, its advisable 1 year because its reduce the risk
Do you mean 3 month between tibias and femurs sergery? Or do you mean 3 month interval before EVERY surgery?
Quote from: Chris on January 01, 2017, 05:44:42 PMWhen lengthening femur and tibia simultaneously, 2mm per day are easily hit and many patients can't stay below that rate, because of pre-consolidation.
No! I didn't mean 2mm per day! What I meant is lenghtening one segment AFTER you've already lenghthened another, but your frames/nails are still in you for consolidation.
Lengthening itself(1mm per day) lasts for a month or so(in case of 3cm, for example), but you will still be in frames for a year after lengthening itself is over, right?
I mean lengthening every segment 1mm per day, but when one is already lenghthened enough and consolidating, do another surgery(with first surgery's frames/nails still in you) and start lengthening second segment 1mm per day.
Is it possible?
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