Penguinn- Precice II internal femurs with Dr. Parihar

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My advice is to start using the walker as much as possible. It will speed up your recovery  a lot.

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Hi Penguinn
I am a 22 yr old male from Delhi, India. I am planning to get unilateral lengthening done on my left leg which is shorter than the right by around 6 cm due to club foot(birth deformity of foot) related surgeries done in the past. The femur region of both legs are equal. All the difference lies in the tibial area.

I met with Dr Parihar 1 year back and he suggested the regular Ilizarov method and LON method but no mention of Precice. I am very much interested in this internal nail method although its a bit too costly for me ( under Rs 15lac is ideal for me). So i want this done only if it gives some major advantage in healing time,less complications etc. And does price reduce for me because i have only one leg to be done ?

If the lengthening is in the tibia and that too of 5-6 cm, do i really need to go for Precice?. Also if i go for femur lengthening i think my tibia:femur ratio will become different in both legs. Is that something that can cause problems? My reason of thinking about femur lengthening is that tibia region of my left leg is very weak due to club foot surgeries while everything above knee is normal.

I urgently want to discuss all this also with Dr Parihar. I am unable to contact him. Can you please PM me his email-id ?.
Good luck with your lengthening 

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Quote from: fauzdar65 on December 01, 2016, 10:06:58 AMHi Penguinn
I am a 22 yr old male from Delhi, India. I am planning to get unilateral lengthening done on my left leg which is shorter than the right by around 6 cm due to club foot(birth deformity of foot) related surgeries done in the past. The femur region of both legs are equal. All the difference lies in the tibial area.

I met with Dr Parihar 1 year back and he suggested the regular Ilizarov method and LON method but no mention of Precice. I am very much interested in this internal nail method although its a bit too costly for me ( under Rs 15lac is ideal for me). So i want this done only if it gives some major advantage in healing time,less complications etc. And does price reduce for me because i have only one leg to be done ?

If the lengthening is in the tibia and that too of 5-6 cm, do i really need to go for Precice?. Also if i go for femur lengthening i think my tibia:femur ratio will become different in both legs. Is that something that can cause problems? My reason of thinking about femur lengthening is that tibia region of my left leg is very weak due to club foot surgeries while everything above knee is normal.

I urgently want to discuss all this also with Dr Parihar. I am unable to contact him. Can you please PM me his email-id ?.
Good luck with your lengthening 

PM'd

I wouldn't recommend Precice to you. Nailing the tibia is harder and can cause more complications, which is why they leave the nailing for the femur. You can definitely lengthen 5-6cms on your tibia. What segment you will lengthen will depend on what Parihar says after checking your leg out and see if the tibia is doable. I'll take a guess and say he'll try to fix any existing problems and try to lengthen the tibia. If you can lengthen even 4.5cms you should be good- Dr. Parihar has told me "a 2cm discrepancy in the legs is the point where a patient can decide whether to fix it or not". Below that you can live with and above that means it should be fixed. So after lengthening that much your discrepancy will be minimal.

I imagine having a different femur:tibia ratio in both legs makes walking and quite a few activities weird since the knees are at different places.

And yes, the Precice nail price will be halved for you since it's only one nail. The surgical cost should also be half, but I'm not sure.

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I doubt you are going to listen to my advice and this is probably a waste of time. If I were you Penguinn, I would stop lengthening at 6.5cm. The reason why is that nobody on the planet is going to notice that extra 1cm that will take you to 7.5cm. It's not going to make any difference at all in your life, and will dramatically increase your recovery time and potential for complications.

Stop now and be happy with the length you have. It's simply not worth the risk to have that meaningless 1cm more of height. You can always go back for more on your tibias once you heal up and get used to your new proportions. Always better to play it safe when it comes to LL, than to chase centimeters or try to achieve the goal you set out before your surgery. In the end 1cm more of height is pointless when you already have 6.5cm.

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Quote from: Lubak on December 01, 2016, 04:01:27 PMI doubt you are going to listen to my advice and this is probably a waste of time. If I were you Penguinn, I would stop lengthening at 6.5cm. The reason why is that nobody on the planet is going to notice that extra 1cm that will take you to 7.5cm. It's not going to make any difference at all in your life, and will dramatically increase your recovery time and potential for complications.

Stop now and be happy with the length you have. It's simply not worth the risk to have that meaningless 1cm more of height. You can always go back for more on your tibias once you heal up and get used to your new proportions. Always better to play it safe when it comes to LL, than to chase centimeters or try to achieve the goal you set out before your surgery. In the end 1cm more of height is pointless when you already have 6.5cm.

Honestly, I see no reason to stop. Things are still painless for me, as of 6.6cms(6.45 if you believe the Precice machine). I get 8 hours of sleep. If I had a lot of pain and couldn't work my muscles during physio I would have stopped. I think it's the age, because Morrisette and Asian123 who are also very young did 3" on their tibias, with externals and seem to be doing fine. My doctor, who's already cautious and prefers function over length, has given me the green signal. My proportions won't look noticeably off with the extra cm. Aside from slight knee bending on the right, which hasn't gotten worse over the past few weeks, I'm fine.

1cm isn't meaningless; it's almost half an inch. Also, going back for more on my tibias isn't that easy. It's not like ordering a second helping at a restaurant. This process takes a lot of time, effort and money and I honestly can't be arsed do it again. Worst case scenario, I'd settle for what I have. I agree that 6.5cms is a life changing gain. But again, I'm listening to my body and I haven't seen any significant indicators of needing to cut my goal short.

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i'm 100 % with you bro !!!! Good luck hope you're fine and your scars are ok . 

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How are you Penguinn? All right? How many mm already got? Good luck

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Quote from: caioOo8900 on December 11, 2016, 02:20:21 AMHow are you Penguinn? All right? How many mm already got? Good luckMy lengthening is done. Somewhere around 7.35 according to the machine's measurement. However, I was told that during lengthening my left leg fell 2mm behind. Now my right leg was naturally 2mm shorter so my legs are equal. Depending on the amount lengthened, which I will know on Monday, I'll lengthen a bit more or stay consolidating.

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Probably this has been the painless experience I have read with Precice, not even Paley has had patients with almost 0 pain. I dont know if age was the main factor or that the doctor is very careful( your operation was completed in 10 hours). I am jealous .

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Happy for you bro wish you the best for your recovery and your futur life . Enjoy