Dr Alex Monegal (Barcelona, Spain) Clinica Diagonal

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Hi Taller

It depends on every individual.i have recently had a few patient's with a ratio close to 1 which means Femur and tibia Are equal. In these cases It is better to Go for femur Otherwise tibiae Will be longer At the end of the lengthening procedure.
Femur shoud be 1.1 times longer than tibiae ideally. But There is a Range in which ratio remains safe and biomechanically correct.

I think there is a post somewhere which explains perfectly about these proportions.

Regards

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Hi Just me

Referring to the operation itself nailing is more invasive for obvious reasons.
The advantage about using internals in my opinion are several.

1- no pins going throught the skin
2- no pinsite infection
3- less pain
4- better COSMETIC results: nitchy scars
5- less axial deviation
6- less delayed consolidation rates
7- early rehab of the knee joint
8- patients can start physical activities earlier (swimming pool/cycling)
9- Patient managing and handling
10- no need cures of the pinnsites
11- less surgical procedures (some of the LL using ex-fix or LON require
12- confort of the patient

So the surgical act might be More invasive as you ream the bone and stick in a nail, but in my opinion there are some factors 'non related' with the surgical act but with patient handling and post operative care, that really makes the system much safer and probably more easygoing.

Regards

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@Dr Alex Monegal, Very informative answer - Thanks.

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@musicmaker,
1) How long did you stay at the Hospital after surgery?

2) Did you stay at a Hotel after you left the Hospital before you went Home - if yes then for
how long did you stay at a Hotel?

3) Are there several Hotels close to the Hospital?

4) Is Barcelona/Spain an expensive country compared to other countries in Europe regarding Hotels, foods, Taxi etc.

Thanks.

Regards

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Hi musicmaker,
Thank you kindly for your good answers. Thank you for offering your help - It's good to know. I wish you the very best with your legs journey.

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Quote from: Dr Monegal on April 25, 2015, 09:29:24 PMFemur shoud be 1.1 times longer than tibiae ideally. But There is a Range in which ratio remains safe and biomechanically correct.
Hello to u all,

To be honest I've allways read that tibias are normally 80% of femurs. But from what you just said, femurs should be 1.1 tibia wich leads to tibias beeing more a less 90% femur.

I am 1,66m and I was planning on lenghtening only 6cm femurs in the future. That beeing the case I would love to know what you doctors believe is the normal ratio and upper and lower limit in which the ratio remains biomechanicaly safe. 

Why I am planning on doing femurs?
- I don't want to be tall I just don't want to be this short (I've lot of friend between 1,70-1,74 but almost none <1,70)
- Two segments would make my sitting height to height ratio look funny
- Tibia recovery time is scary

My dream is to get 6-6,5 in femurs so I would love to know what you have to say about the femur to tibia ratio 

Thank you,

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Hi wazzup

Probably I Did not express myself correctly.
I meant we need to keep ratio so It does not go underneath 1.1 at the end of lengthening.
Depending on the x rays, 6 cm femur in your case could be a good solution If This is a biomechanically correct procedure.

Regards

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Dear, Dr Monegal

May I know what is the chance of losing the achieved length during the internal nailing surgery of LATN method?
How much can u lose? Is there any surgical method to prevent it from happening at all?

I would really appreciate ur help. Thanks
BB

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Hi Dr Monegal,

Are there any advantages that you see Fitbone having over the Precice nail?

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Hi bluebarbie

I don t do LATN procedure.
To prevent the callus to colapse best is to wait until the bone consolidation is enought so It does not collapse. Callus is elastic structure and if ex fix is removed straight away after lengthening is finished you will lose lengthening.
Best is to nail and lock the nail before removal of the ex fix in the procedure. Doing This you will not lose Any length.

Kind regards