External Tibias and embolism risk

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Quote from: Whereintheworld? on December 17, 2016, 11:45:19 PMThis is exactly why I chose externals. As you mentioned, the consensus on this forum is that internals are superior, but given the reasons you listed I don't understand why. To each his own I suppose.

Internals are superior in many ways, I just don't buy that they're definitely superior.

For comfort, internals are superior, as there are no external parts interfering with your clothes or sleep. Taking shower or bath is also made possible or should I say more comfortable.

For short-term recovery, internals should also superior, because they allow quicker weight-bearing than pure externals. The faster you start weight bearing (I mean walking with no support), the sooner you should recover.

However, they are indeed studies on knee pain and nailing. Also, with internal femur nailing you'll be throwing off your mechanical axis causing knee misalignment which can be visible and measured on standing xrays. This has been noted by both guys at Ilizarov's Centre (Kurgan) and RNIITO (St. Petersburg). If fact, I've read a study from Kurgan exclusively on the matter of mechanical axis and femur lengthening and they've concluded that internal femur lengthening unavoidably leads to arthritis. So while internals are indeed better for short-term recovery, what about long term effects on your knee joints?

And let's not talk about the pricing of internal LL. It's hyped and advertised as "superior" and "pain free" method of LL, which is just a PR-strategy.

QuoteAnyone heard of the hybrid external fixator? Supposed to be the improved more modern version of the traditional.

Yes. They use these at RNIITO (Solomin and Kulesh). They are a combination of pins and rods (stronger, thicker pins basically). They offer more stability and weight bearing and are an improvement of the old standard Ilizarov's Apparatus they still use at Ilizarov's Centre (Kurgan).

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Quote from: Dozer on December 18, 2016, 02:07:45 AMInternals are superior in many ways, I just don't buy that they're definitely superior.

For comfort, internals are superior, as there are no external parts interfering with your clothes or sleep. Taking shower or bath is also made possible or should I say more comfortable.

For short-term recovery, internals should also superior, because they allow quicker weight-bearing than pure externals. The faster you start weight bearing (I mean walking with no support), the sooner you should recover.

However, they are indeed studies on knee pain and nailing. Also, with internal femur nailing you'll be throwing off your mechanical axis causing knee misalignment which can be visible and measured on standing xrays. This has been noted by both guys at Ilizarov's Centre (Kurgan) and RNIITO (St. Petersburg). If fact, I've read a study from Kurgan exclusively on the matter of mechanical axis and femur lengthening and they've concluded that internal femur lengthening unavoidably leads to arthritis. So while internals are indeed better for short-term recovery, what about long term effects on your knee joints?

And let's not talk about the pricing of internal LL. It's hyped and advertised as "superior" and "pain free" method of LL, which is just a PR-strategy.
Yes. They use these at RNIITO (Solomin and Kulesh). They are a combination of pins and rods (stronger, thicker pins basically). They offer more stability and weight bearing and are an improvement of the old standard Ilizarov's Apparatus they still use at Ilizarov's Centre (Kurgan).

People think Internals are safer because doctors like Dr. Paley and Guichet say they are the more advanced and better options. But what people don't realize is they made the nails and make tons of profit off you!!
"why drive a toyota camry, when you can be driving a lamborghini"
--maybe because even though the camry is slower, it is less expensive and safer than a 160 mph Lamborghini.

LL Doctors have a business, and they make millions off of the internal methods. If you actually do research on both methods, you will find that external tibias are a lot better in terms of safety (both short term and long term) in comparison to internal femurs.

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if i get this surgery, it will most likely be with Dr. Solomin using externals with 6 axis correction system for 4 cm gain (tibs)

Thank you to everyone who contributed to this post and tried helping me out!

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Quote from: Dozer on December 18, 2016, 02:07:45 AMI've read a study from Kurgan exclusively on the matter of mechanical axis and femur lengthening and they've concluded that internal femur lengthening unavoidably leads to arthritis. So while internals are indeed better for short-term recovery, what about long term effects on your knee joints?

What if internal femur lengthening is done by inserting nail through the hip rather than knee as some people have suggested for those reluctant to imagine the possibility of perm knee pain. Plus external femur is not an option and almost every doctor is against it since it's incredibly painful and complicated.

General golden rule is External for tibias and Internal for femurs.

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Quote from: Desktopx on December 18, 2016, 09:36:58 AMPlus external femur is not an option and almost every doctor is against it since it's incredibly painful and complicated.

It's an option and I've already explained why it's a better long-term option. It's not more painful and I'm tired of hearing that argument - the only times my pin sites hurt was when there was inflammation present and it was rare for me. The most pain comes during the lengthening phase around the lengthening site due to... the lengthening itself and its effects on the soft tissue. In fact, external femurs are probably less painful than some internals - because you don't have to "click" your leg 10000 times a day. All you have to do is turn screws by 90 degrees 4 times a day.

The only valid argument for internal over external femur is the comfort, as lengthening femurs externally is VERY uncomfortable.

Also, "most" doctors don't do it because they're already involved in internal lengthening and it's much more profitable for them. And also because most doctors don't have enough experience with arranging external lengthening device on the femurs.

(I'm done arguing)

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Embolism is very rare stop talking about it. you may die because of Anesthesia while attempting surgery, its almost same percentage. focus on complications and recovery thats what matter.

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Quote from: Dozer on December 18, 2016, 10:49:11 AMIt's an option and I've already explained why it's a better long-term option. It's not more painful and I'm tired of hearing that argument - the only times my pin sites hurt was when there was inflammation present and it was rare for me. The most pain comes during the lengthening phase around the lengthening site due to... the lengthening itself and its effects on the soft tissue. In fact, external femurs are probably less painful than some internals - because you don't have to "click" your leg 10000 times a day. All you have to do is turn screws by 90 degrees 4 times a day.

The only valid argument for internal over external femur is the comfort, as lengthening femurs externally is VERY uncomfortable.

Also, "most" doctors don't do it because they're already involved in internal lengthening and it's much more profitable for them. And also because most doctors don't have enough experience with arranging external lengthening device on the femurs.

(I'm done arguing)

I read a thread of yours where you have described your experience with Dr. Solomin. I see you cross lengthened tibia and femur externally by 7.5 cm each (Total 15 cm). How did your surgeries go in terms of complications as many people here, based on experiences, agree that 7.5 cm on the tibias is just way too much and will most likely result in hardship. How are you doing today? Can you run normally and possess normal functional athletic ability?

Also what do you think of Dr. Barinov compared to Solomin?

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Quote from: Desktopx on December 18, 2016, 06:44:06 PMI read a thread of yours where you have described your experience with Dr. Solomin. I see you cross lengthened tibia and femur externally by 7.5 cm each (Total 15 cm). How did your surgeries go in terms of complications as many people here, based on experiences, agree that 7.5 cm on the tibias is just way too much and will most likely result in hardship. How are you doing today? Can you run normally and possess normal functional athletic ability?

My surgeon was Dr. Kulesh, not Solomin.

5 cm is just a general rule for tibia lengthening. It's all individual and in my case I completely recovered both my knee ROM and ankle ROM. Though I've seen people who lengthened just 5 cm on tibs with very bad ballerina feet and also bad knee contracture. Depends on your soft tissue "flexibility".

I can walk normally, but I was never athletic and running wasn't my thing, so I didn't even try yet. Plus I've been recovering my knee and ankle ROM and my muscle mass mostly all this time so it was too early to try anyways. I may buy a treadmill later on to practice running.


QuoteAlso what do you think of Dr. Barinov compared to Solomin?

Dr. Kulesh is better than both.

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Does kulesh offer LON?

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"However, they are indeed studies on knee pain and nailing. Also, with internal femur nailing you'll be throwing off your mechanical axis causing knee misalignment which can be visible and measured on standing xrays. This has been noted by both guys at Ilizarov's Centre (Kurgan) and RNIITO (St. Petersburg). If fact, I've read a study from Kurgan exclusively on the matter of mechanical axis and femur lengthening and they've concluded that internal femur lengthening unavoidably leads to arthritis. So while internals are indeed better for short-term recovery, what about long term effects on your knee joints?
"

Could you please refer to this study, where can I/we read this?