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.
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.
Quote from: Leonard Shelby on December 21, 2023, 10:59:10 PMSadly, 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.
Quote from: Leonard Shelby on December 22, 2023, 12:06:28 PMIt 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.
Quote from: Leonard Shelby on December 22, 2023, 11:44:09 AMAlso, 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.Interesting. Why do you think external is harder to perform for the surgeon?
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
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.
Quote from: Hobbit99 on December 22, 2023, 03:40:18 PMInteresting. Why do you think external is harder to perform for the surgeon?
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.
Quote from: Leonard Shelby on December 22, 2023, 11:15:55 PMFor 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.So if I want an extra 7 cm of height, external femurs is the best way?
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.
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.
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."
Yeah, been there, done that.
You must be logged in to post a reply.