Since there is no universally agreed-upon "best" amount of femoral lengthening. What do you think based in your experience the best amount you advise for?
Quote from: TheDream on May 23, 2023, 09:46:35 PMI think it’s highly individual based on the risk/reward you’re willing to go for.
Let’s say you have infinite money, or at least money is no issue. Then I would personally go for a modest amount like 4 cm on femurs, and then later 3 cm on tibias. This strategy would be to try and limit long term problems like ballerina that is caused by the Achilles’ tendon strain from the tibia lengthening, and also the duck ass from the strain on the IT band from the femur lengthening.
But in a realistic scenario money is the main issue. So if you can’t save up forever then maybe it is a better strategy to go for just femurs and then lengthen 6 cm on femurs and then just deal with the duck ass through lots of PT and hope you can walk long distances / run one day without any issues.
Then again maybe the increased risk from lengthening 6 cm femur instead of 4 cm is actually not that high. But this is the issue I find the most interesting about LL. How significant is the total lengthening amount and the lengthening speed for long term recovery of athletic ability? I wish we had more research on this.
I'd say even if money is not an issue avoiding two surgeries (4 nails) would still be a smarter strategy for the long term but i could be wrong, but with that in mind, the patient would be limited to the amount lengthened (best cases i saw from one surgery are usually under 6cm femurs and the full recovery time is usually less than a year) which for me is a far better deal.
But realistically speaking, most of people in this forum would find anything under 6cm extremely underwhelming.
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