Hello, I am a 20-year-old boy with height of 168cm. I plan to do LL with Dr.kulesh from Russia in November of this year. My goal is 5cm for tibias and i decide to choose method of conventional Ilizarov.
Any body give me some advice? Is my choice wise?
I plan to stay in Russia for about 1 month and do the extension at home.
Quote from: Ghostfish on April 20, 2019, 06:48:04 AMHi jievince3
I don't understand why you chose the oldest method, Ilizarov. Is that because of money? Try to choose at least LON if you care about money. There are many doctors who are doing LON at low price.
Yes, it's much cheaper. And based on what I got on the forum(I am not sure about it), llizarov is more safe than LON and llizarov can reduce damage to exercise capacity for tibias.
Quote from: Ghostfish on April 21, 2019, 06:36:39 AMHi jievince3
I see your concern about money. Of course, money is the biggest concern for the most. I did cll with internal nail, Stryde and never had any intention to use external method for my cll. So I don't know very well about external method. But one thing for sure is that most of people who did external method, generally for only tibia, used LON rather than Ilizarov. I think there must be a reason for that. Plus, as far as I know about external method including Ilizarov, the external method is slower than internal method and more problem of infection and perhaps complication. I guess Ilizarov is probably worse than LON. Look for more information before you really do it. I really discourage you to do Iliarov.
Hi Ghostfish, thanks for your interest. I think why why people prefer LON is because LON takes less time to remove frames.
Money is my key problem and I can only afford about $8,000. To be a short man is very painful so I want to do LL as early as I can.
If I have enough money, I will definitely choose stryde.
Quote from: wannagrowtaller on April 21, 2019, 02:14:31 PMThe problem with LON (and LATN) is the problem with internal nail in tibia: risk of permanent knee pain. If the surgeon perform suprapatellar approach the risk is reduced. There is not risk with full external.
Thanks for your answer. So conventional Ilizarov is more safer than LON/LATN?
Quote from: California2 on April 21, 2019, 04:51:44 PMYou seem intent to lengthen only 5 cm (which is modest and probably very safe depending on your starting tibia length).
Purely external lengthening (Ilizarov without nails) remains the safest approach and offers the ability to resolve existing alignment issues, if any.
If you plan on actually stopping at 5 cm; then, it is probably safe enough to leave St. Petersburg during distraction; however, you may need to return for a correction phase after distraction is complete but before your frames are locked for consolidation. You will also likely need to return to remove the frames. When you plan to go beyond 5 cm, you should carefully question whether you should be geographically distant from your medical team because your body will push back very hard against lengthening which can necessitate adjustment to your frames.
If you limit distraction to 5 CM; then, you are probably looking at about 2 months from initial surgery to completion of distraction, another one to two weeks for correction; then, 2-3 months for consolidation -- a doable journey in frames.
You can always elect LATN later if you want to get rid of the frames. Though people on this forum insist LON or LATN causes knee pain, etc., I am aware of no valid, on-point study that supports that notion. I can also attest that I have no knee pain or loss of range of knee motion.
I encourage you to discuss your choices frankly with your MD team. Dr. Kulesh will accept your decisions and make what you want to happen actually happen because he ascribes to the doctrine that "the patient is always right".
However, most patients are dumb as a post when compared to his or her physician. Therefore, it is always important to ask your medical team "what do you advise?" Carefully consider that advice and the underlying rationale before you decide to not follow it.
Best of luck!
Thank you very much for your reply and suggestions. Also, do you think kulesh is a good doctor? There seems to be no negative news about kulesh at the forum.
Quote from: wannagrowtaller on April 21, 2019, 05:33:03 PMhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5333649/
Okay, I will read it.
Quote from: Renaissance on April 21, 2019, 07:31:44 PMso to answer your question'' is my choice wise?'', from my point of view the answer is no.
and in my opinion it is simply because the pain you feel and the eagerness you have to eliminate it prevents you from reasoning rationally
Hi, thanks your reply.
If I have $100,000, I will no doubt choose paley; if I have $50,000, I will choose Giotikas. However, I only have $8,000 now. I need to make a relatively good decision. For the extension of the tibia, the traditional Irizhalov is very safe, 5cm is also a relatively safe length, in addition, Dr. Kulesh also has a good evaluation.
Why is this not a good choice?
(English is not my first language, I may be unclear in some places, sorry.)
The length of my tibia is about 40cm.
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