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Posted on Jun 18, 2026, 8:33 pm
#1
Is lengthening the tibia by 5.5 cm dangerous, or is it better to settle for 4 cm?
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Posted on Jun 18, 2026, 8:33 pm
#2
4 cm is better, doesn't worth that additional cm due to risks of ballerina feet and delayed union or even non-union. Remember RGKey's case who did 9 cm and got very bad malunions.

IMO, 4 cm is very noticeable for tibia and 5 cm for femur, there's no need for more lengthening.

Especially when doing pure external, 4 cm will consolidate quickly and you remove the frames soo than doing more than that.
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Posted on Jun 18, 2026, 8:33 pm
#3
5.5 cm are very safe for tibias if you go to an experienced doctor.
For 4cm LL doesn't even worth the money and the risks. 
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Posted on Jun 18, 2026, 8:33 pm
#4
What happens to those who get ballerina? Is it something easily solved by rehab?
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Posted on Jun 18, 2026, 8:33 pm
#5
I've seen a couple people now claim that 5 cm tibias is risky, but I haven't seen any actual posts by people with a 5 cm increase claiming there have been permanent complications.

Sweden had some serious complications at 7 cm tibias, but even he eventually got back to full athletic ability.

As long as Paley says that 5 cm or below is safe I'm inclined to trust him.
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Posted on Jun 18, 2026, 8:33 pm
#6
5.5 cm are very safe for tibias if you go to an experienced doctor.
For 4cm LL doesn't even worth the money and the risks.
What is the max safe amount on tibias, is it 6 or 7 cm?
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Posted on Jun 18, 2026, 8:33 pm
#7
It's been stated many times on this forum by various doctors that after about 5 cm it starts really tight and complicated. So, for average person, it's about 5 cm, for some it's - 6 cm. More than 6 cm is very dangerous for anyone.

And, for tibia, 6 cm is the same as 8 cm on femur in terms of percentage of distraction of the bone. It's a significant increase for that segment and it will look much longer after 6 cm, the same way femur looks much longer after 7.5 cm.
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