Hybrid External Fixator (HEF) or Lengthening over Nail (LON) for tibia 5cm

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So it appears HEF has it's advantages over the pure external i.e. a bit more comfort and maybe a little faster, less recovery time? Are the risks of permanent knee pain from LON not worth it over the external/HEF or do the advantages from LON outweigh it and is a better option in terms of pain and recovery (and also sleep since it's almost impossible to sleep well with the frames on - also have to sleep on the back and not all people can do that).

Why it concerns me because I heard the risks of knee pain from LON are really not that high as people think they are - it's just a misconception?
External frames, as a general consensus, are the most mentally as well as physically challenging method of LL a person can undergo.

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Tibia nailing has a 5-10% chance of causing knee pain it's nothing like 70% like the reports say. Still 5-10% is still a gamble.

Yes as well to those other concerns external fixators are high in the pain and discomfort stakes. I agree as well do not do external fixators if you cannot sleep on your back as you will have months on end of insomnia. Pin sites are painful a lot of the time as well and walking on fixators is painful also. Not many people could or can tolerate external fixators both mentally and physically