Dr Paley used to reccommend safe limit in tibias as 6.5cm

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Quote from: Highest on January 14, 2021, 05:05:52 AMIn all of cyborg4lifes interviews with Doctors from Paley to Lee they all said the bone can be lengthened much further than soft tissue due to limits with the tendons and ligaments having fixed amount of stretch in them. I can't find any information which shows that ligaments and tendons will grow and not stretch. Can you link any sources.

I have literally watched both those interviews with Victor from cyborg from life and I am pretty sure they both mention the growth of brand new cells not just solely stretch

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Quote from: MakeMeTallAF on January 14, 2021, 06:05:00 AMhttps://link.springer.com/chapter/10.1007/978-1-4471-0691-3_4

The soft tissues are the limiting factor because like I said they don't grow fast enough to keep up with the lengthening of .5 to 1mm/day. Paley himself has said the soft tissues grow as well.

"   Ilizarov in 1951 began developing his methods of “distraction osteogenesis”. He developed the process of new bone (termed regenerate) and soft tissue regeneration under the effect of slow and gradual distraction. Gradual traction on living tissue creates stresses that can stimulate and maintain the regeneration and active growth of certain tissue structures, termed the “law of tension stress” (Ilizarov, 1989; Paterson, 1990). "

Seriously look up distraction osteogenesis. It is the process being used in limb lengthening. Study up on it, and rewatch the Rozbruch and Paley interviews they mention it briefly too.

Thanks for the source. My understanding that the 0.75mm per day tibia and 1mm per day femurs was the speed which was meant to prevent preconsolidation. People then get contractures from the muscle being lengthened too fast at these speeds and creating scar tissue rather than regular tissue. If we could lengthen without the worry of preconsolidation the only concern would become remaining proportional as soft tissue issues are then removed. Is there something I'm missing here?

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Quote from: Highest on January 14, 2021, 11:43:58 AMThanks for the source. My understanding that the 0.75mm per day tibia and 1mm per day femurs was the speed which was meant to prevent preconsolidation. People then get contractures from the muscle being lengthened too fast at these speeds and creating scar tissue rather than regular tissue. If we could lengthen without the worry of preconsolidation the only concern would become remaining proportional as soft tissue issues are then removed. Is there something I'm missing here?

Yup this is exactly right from my understanding. The thing with LL is that it is just like how we grow during puberty (well except for the breaking your bones part), the main difference is that the distraction rate is way too fast for the soft tissues to actually keep up. If we could find a way to slow down the distraction rate while eliminating the risk of pre-consolidation, we would be able to get closer to 100% recovery and possibly even lengthen longer distances. I don't think there are any soft tissues that do not grow along with the bone, it's just that when they can't keep up they form scar tissue.

This could be a good question to ask to a doctor though, for anyone doing a consultation.

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Quote from: Highest on January 14, 2021, 11:43:58 AMThanks for the source. My understanding that the 0.75mm per day tibia and 1mm per day femurs was the speed which was meant to prevent preconsolidation. People then get contractures from the muscle being lengthened too fast at these speeds and creating scar tissue rather than regular tissue. If we could lengthen without the worry of preconsolidation the only concern would become remaining proportional as soft tissue issues are then removed. Is there something I'm missing here?

Yes and no.


1mm per day comes from Dr. Ilizarov’s research  about the best yield in bone formation, But also that’s what the nerves and vessels will tolerate before stopping to work...

0.75mm/day in the tibia comes from the fact that the nerves are of smaller caliber and don’t tolerate stretching as much. The same way soft tissues don’t necessarily like to be stretched as much .

I am a limb lengthening surgeon a d that’s what I do every week. my advice is to be reasonable and to listen to your surgeon. Most surgeons have your best interest at heart. I know I do.

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Speaking with Dr. Paley and Dr. Robbins, the limit was changed to 5cm because they consistently found too many people had big difficulties reaching 6.5cm.

In fact, speaking with recent patients who underwent quad surgery (surgery on both segments, 3 weeks apart)--most do not do 5cm femurs/5cm as is advertised by their combined plan. Most instead do 6cm femurs/4cm tibs because it's just plain hard to lengthen tibs compared to femurs.

I can't say for sure myself as I have not had surgery yet.

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What are your current thoughts on the safe limits and splits for most people?

Ex:

1. is 7.5 cm on femur, wait a year then do 6 cm on tibia safe for most people? Or should be different numbers/less lengthening for most people?

2. is 7 cm on femur, wait a month, then do 3-4 cm on tibia safe or too much when doing LL back to back like this with only a month rest in between? Ex: then rebreak tibia a year later to get to 6 cm on tibia, bad idea?

What are your recommended limits? For say adult males 5'6-5'7 starting height

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I wouldn't go over 5 cm on tibias even if i'd be dead.

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People hit 6cm on tibias all the time. 6.5 being the limit seems like a reasonable recommendation.

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"May 2021: 170cm (evening) > September 2021: 180cm"

You hit 10 cm w/ Betz?

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Most German surgeons I have spoken with don’t recommend going over 6,5cm on femurs.