I'm disappointed that even the top suregons favor internal method (Rant)

Member

Posts: 498

Joined: Dec 2023

Posted on Dec 21, 2023, 10:59 pm

#1

We would think that if there was an advanced method, it would be something safer and less invasive.

But no, LL used to be a rather simple external method, just separate the the bones in a controlled manner and put the fixators on. Sadly, it's followed up by something a lot of more invasive that would only increase the chance of embolism complications where not only you have to break the bones, but also drill the fukc out of them.

I mean why on earth would you want to do that? (Except for femurs) The original LL (external method) is already dangerous and painful enough that most people won't even do it, the last thing we need is taking more unnecessary risks by doing it internally.

I wish that instead of them being so busy marketing PRECICE or Stryde or what ever the fukc it is called, more efforts and resources are allocated at the perfection of the already existing and superior external method to make it even safer that it has ever been.

More read on this: http://www.limblengtheningforum.com/index.php?topic=84060.msg265525

Like (0)

L

Lennys

Member

Posts: 385

Joined: Dec 2023

Posted on Dec 21, 2023, 11:16 pm

#2

Quote from: NailedLegs on December 21, 2023, 11:10:47 PMI think I made a pretty good argument for why internals are better, citing all of my sources.

No, but Body Builder and Medium Drink Of Water did for externals.

Quote from: NailedLegs on December 21, 2023, 11:10:47 PMIf you're going to do externals, please make sure you pick a reputable Doctor.

Yeah, absolutely. That applies to whatever method you choose.

Like (0)

L

Lennys

Member

Posts: 137

Joined: Dec 2023

Posted on Dec 22, 2023, 5:31 am

#3

Quote from: NailedLegs on December 22, 2023, 05:21:37 AMBodybuilder and Medium Drink of Water didn't cite a single source. I'm not sure why you said no.

If you took anecdotes and random strangers online over peer reviewed studies and Doctor's statements, I don't know what to tell you. It was a great thread that had differing viewpoints--iron sharpens iron. It sounds like you already made up your mind with doing externals. I wish you good luck. There are reputable surgeons that do externals like Dr. Parihar, and he is probably the most inexpensive option. I understand you want a cheap option, as thats the #1 reason why people do externals. Perhaps you should research him?

I've said it before. I would rather do externals will a skilled and reputable Doctor than doing internal with a butcher like Buldu. Doctor > Method.

As the others have pointed out in that thread, none of your sources are relevant. Minor complications don't mean much, it's only the serious ones that matter.

Even if the prices were the same, I'd still choose external mainly because I prefer the low-invasiveness of externals compared to the shudder-inducing brutality of not one but two major surgeries for internals.

As for the reputable doctors, I believe we have different standards for what qualifies as good doctors. Like I wouldn't do this surgery in India with Dr. Parihar or with an unknown doctor like Dr. Kucukkaya or with a surgeon who has killed a patient like Dr. Giotikas.

Like (0)

L

Lennys

Member

Posts: 352

Joined: Dec 2023

Posted on Dec 22, 2023, 6:39 am

#4

Quote from: NailedLegs on December 22, 2023, 06:13:43 AMYou are trying to justify your bad decisions to make yourself feel better. That's a common thing humans do. I get it.

Sounds more like you're trying to justify your bad decisions of doing QLL in Early 2025 with the PRECICE nail with a bunch of shady surgeons as candidates.

Like (0)

L

Lennys

Member

Posts: 47

Joined: Dec 2023

Posted on Dec 22, 2023, 11:44 am

#5

Quote from: Body Builder on December 22, 2023, 11:14:35 AMWell said.
Externals only for tibias with hexapod is definitely the safest, most painless and cheap method. The only reason that many famous doctors don't do it is that they have way less profit than using magnetic nails or mechanic cr*ps. Still, respectable doctors like Giotikas and Pili use it.

Also, another reason is that external method is harder to perform requiring the surgeon to be way more skilled. It is basically more work for them so internal is less headache for them.

Like (0)

L

Lennys

Member

Posts: 275

Joined: Dec 2023

Posted on Dec 22, 2023, 12:06 pm

#6

Quote from: TheDream on December 22, 2023, 11:57:38 AMOne thing I’ve wondered about with internals tibia is how they can control the axis of the fibular bone, because it’s only the tibia that has the device inside of it. I guess the nails keep the fibular in place as well? Maybe this only becomes an issue for larger lengthening amounts on tibia >3-4 cm?

But overall not having the pins that connect the outside world with the bone through the muscles surely makes internals better than externals. I mean sure the internals is a larger initial procedure but if the surgeon is good at what he does then there shouldn’t be an issue and the chance of complications after the surgery will be less.

Also increased mobility of internals.

It doesn't matter how good the surgeon is. The point is with internals, your body takes a lot more damages than necessary so the risks are inherently higher.

Like (0)

L

Lennys

Member

Posts: 80

Joined: Dec 2023

Posted on Dec 22, 2023, 11:15 pm

#7

Quote from: erlang on December 22, 2023, 02:43:04 PMCould you please refer to some source that states that the internal method has a higher risk of embolism than the external method?
The only comment I have seen on this forum about embolism is from Dr. Assayag and it is quite positive
http://www.limblengtheningforum.com/index.php?topic=65693.msg182778#msg182778

For starters, Dr. Paley the GOAT had 2 embolism cases who almost died through internal method and he's the best in the world. Let that sink in. Now feel free to find us an embolism case through external method.

It's a common knowledge that the internal method has a higher risk of embolisms. The reason you don't see it mentioned often enough is the very reason that I made this thread. Most of the surgeons aren't very open about it but if you ask them this specifically and corner them enough, they'd have no choice but to admit it.

Quote from: CLLvet on December 22, 2023, 03:31:40 PM
I did internals with my femur (Stryde) and then externals on my tibia (Taylor Spatial Frames LATN) a few years later. Both surgeries with Giotikas.

I will say that externals were challenging, but not as bad as I thought they would be. The physical pain was minimal (in fact it was less painful than internal Stryde femurs). I remember when I did Stryde on my femurs I would wake up in the middle of the night due to actual physical pain inside my femur bones. Whereas with the externals, I rarely (if ever) felt any physical pain in my tibias. The main challenge with the externals is the discomfort because your body never truly gets used to having frames on your legs, especially at night while you sleep. However, I did eventually adjust and found myself being able to fall asleep. My sleep quality was not dramatically different when comparing my experience with externals versus internals. As mentioned earlier, pain awakened me at night during my femur CLL. Whereas it was physical discomfort that awakened me at night during tibia CLL. So different issues, but both disrupt your sleep quality. And I dealt with both by standing up, doing some quick stretches, adjusting my body position, and laying back down in bed. I should also caveat that I am not good at sleeping and have always struggled with sleep to an extent (regardless of CLL or not)

Finally, having a surgeon who KNOWS how to properly attach the pins/ rods is critical if you do externals. Your doctor can put the pins/ fixators on in such a way that it minimizes the discomfort and pain to the patient. This is something that Giotikas actually knows how to do quite well due to his experience with treating orthopedic trauma patients.

Perhaps I am one of the few veterans on this forum who has experience with BOTH internal and external. I can speak to the differences in my experience with the two methods if that is something you are interested in. Feel free to post your specific questions here on this thread or reach out to me via DM.

That's wonderful! Thanks for sharing man. Here's the type of answers that people are looking for coming to this thread.

The physical pain inside the femur does sound quite scary but unfortunately, still the only way for femoral lengthening.

Quote from: Hobbit99 on December 22, 2023, 03:40:18 PMInteresting. Why do you think external is harder to perform for the surgeon?

It's not what I think. I'm not a surgeon but that's what the surgeons I spoke with told me. But one of the reasons might be the one that the poster above me has pointed out "Finally, having a surgeon who KNOWS how to properly attach the pins/ rods is critical if you do externals."

Quote from: Kintaeryos on December 22, 2023, 07:22:23 PMomg everytime I think I've understood the labyrinthine theory and factors involved in this complex surgery some new curveball comes up. I thought it was fully established that internal is superior to external in every way except the cost. I guess I still have a lot of research left to do.

Yeah, been there, done that.

Edit Post

Quote from: erlang on December 22, 2023, 02:43:04 PMCould you please refer to some source that states that the internal method has a higher risk of embolism than the external method?
The only comment I have seen on this forum about embolism is from Dr. Assayag and it is quite positive
http://www.limblengtheningforum.com/index.php?topic=65693.msg182778#msg182778

For starters, Dr. Paley the GOAT had 2 embolism cases who almost died through internal method and he's the best in the world. Let that sink in. Now feel free to find us an embolism case through external method.

It's a common knowledge that the internal method has a higher risk of embolisms. The reason you don't see it mentioned often enough is the very reason that I made this thread. Most of the surgeons aren't very open about it but if you ask them this specifically and corner them enough, they'd have no choice but to admit it.

Quote from: CLLvet on December 22, 2023, 03:31:40 PM
I did internals with my femur (Stryde) and then externals on my tibia (Taylor Spatial Frames LATN) a few years later. Both surgeries with Giotikas.

I will say that externals were challenging, but not as bad as I thought they would be. The physical pain was minimal (in fact it was less painful than internal Stryde femurs). I remember when I did Stryde on my femurs I would wake up in the middle of the night due to actual physical pain inside my femur bones. Whereas with the externals, I rarely (if ever) felt any physical pain in my tibias. The main challenge with the externals is the discomfort because your body never truly gets used to having frames on your legs, especially at night while you sleep. However, I did eventually adjust and found myself being able to fall asleep. My sleep quality was not dramatically different when comparing my experience with externals versus internals. As mentioned earlier, pain awakened me at night during my femur CLL. Whereas it was physical discomfort that awakened me at night during tibia CLL. So different issues, but both disrupt your sleep quality. And I dealt with both by standing up, doing some quick stretches, adjusting my body position, and laying back down in bed. I should also caveat that I am not good at sleeping and have always struggled with sleep to an extent (regardless of CLL or not)

Finally, having a surgeon who KNOWS how to properly attach the pins/ rods is critical if you do externals. Your doctor can put the pins/ fixators on in such a way that it minimizes the discomfort and pain to the patient. This is something that Giotikas actually knows how to do quite well due to his experience with treating orthopedic trauma patients.

Perhaps I am one of the few veterans on this forum who has experience with BOTH internal and external. I can speak to the differences in my experience with the two methods if that is something you are interested in. Feel free to post your specific questions here on this thread or reach out to me via DM.

That's wonderful! Thanks for sharing man. Here's the type of answers that people are looking for coming to this thread.

The physical pain inside the femur does sound quite scary but unfortunately, still the only way for femoral lengthening.

Quote from: Hobbit99 on December 22, 2023, 03:40:18 PMInteresting. Why do you think external is harder to perform for the surgeon?

It's not what I think. I'm not a surgeon but that's what the surgeons I spoke with told me. But one of the reasons might be the one that the poster above me has pointed out "Finally, having a surgeon who KNOWS how to properly attach the pins/ rods is critical if you do externals."

Quote from: Kintaeryos on December 22, 2023, 07:22:23 PMomg everytime I think I've understood the labyrinthine theory and factors involved in this complex surgery some new curveball comes up. I thought it was fully established that internal is superior to external in every way except the cost. I guess I still have a lot of research left to do.

Yeah, been there, done that.

Like (0)

L

Lennys

Member

Posts: 231

Joined: Dec 2023

Posted on Dec 22, 2023, 11:51 pm

#8

Quote from: Kintaeryos on December 22, 2023, 11:32:03 PMSo if I want an extra 7 cm of height, external femurs is the best way?

Femurs have to be done via internal but none guarantees that much height for you. It depends on the your initial bone length. Also, because femurs are curve, it means you might not get the full height increase.

Like (0)

L

Lennys

Member

Posts: 408

Joined: Dec 2023

Posted on Dec 23, 2023, 12:18 am

#9

Quote from: Kintaeryos on December 23, 2023, 12:14:58 AMOh, so your comparison only applies to tibial lengthening?

Yes.

Quote from: Kintaeryos on December 23, 2023, 12:16:13 AMIs externals for tibias safer and less painful than internal femurs? Assuming only 5-6 cm since more than that usually isn't possible with tibias.

Yes, I believe that externals for tibias is superior to internal femurs.

Like (0)

L

Lennys

Member

Posts: 276

Joined: Dec 2023

Posted on Dec 23, 2023, 12:24 am

#10

Quote from: Kintaeryos on December 23, 2023, 12:21:41 AMInteresting, I've never heard this opinion before, will have to do some reading. Do you think even if someone went to the best doctors they wouldn't be able to get an accurate answer to this cause the doctor might have an incentive to recommend internal so they make more money?

Yes, as the other veteran has said above, it's more and easier money for them. That's all.

Like (0)

I'm disappointed that even the top suregons favor internal method (Rant)

Edit Post

Edit Post

Edit Post

Edit Post

Edit Post

Edit Post

Edit Post

Edit Post

Edit Post

Edit Post

Related Topics