Plating should be more popular

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Plating removes potential for permanent knee pain, decreases time in ex fix and the plates that exist now are full weight bearing.

Are there any reasons why it isn't more popular?

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Scary Scars!!

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Modern techniques of plating cause less scars and cosmetic scar removal is not astronmically expensive

The only other issue is there not being enough academic research on adults.

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Quote from: gerrard on March 07, 2015, 08:08:39 AMModern techniques of plating cause less scars and cosmetic scar removal is not astronmically expensive

The only other issue is there not being enough academic research on adults.

Yeah after seeing this pic http://imgur.com/qJGjUB5 , seems like Plating is really so less invasive... OMG now even I have got the same doubt why is PLATING not so famous!!! (?)

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Seems like such a good idea. I don't get why people let a freaking nail go through their knees in the first place. It makes sense that the actual tibia or femur can sustain more damage than the freaking knees with so many moving parts.

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How you gonna lengthen with just a plate? Have you seen self-lengthening plates? How much stability/weight bearing does it offer? Common sense tells me it will be less than with the nails.

Quoteseems like Plating is really so less invasive... OMG

Yea right.

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Plating is used extensively in trauma patients and majority of them seem to be unilateral cases. However, there are only a few surgeons that are willing to perform LAP on normal CLL patients and that is why it's not very popular method. I think the reason why plating is not a preferred method for CLL by majority of the doctors is because of lack of clinical studies, questionable weight bearing capability and its effectiveness in adult bilateral cases. The following surgeons do offer plating as an option from the LL doctors directory:
-Dr.Birkholtz
-Dr.Inan
-Dr.Dhawan
-Dr.Shah
-(Dr.Rozbruch-I think he does offer LAP to CLL patients)
In this study by Dr.Rozbruch (http://www.limblengthening.com/pdfs/Lengthening%20and%20Then%20Plating.pdf), the average external fixation index for both plating and pure externals is 1.5 and 2 months/cm respectively. Dr.Rozbruch notes the higher prevalence of regenerate collapse and varus deformity associated with plating, plus the two broken plates. Therefore the strength and the weight bearing ability of the plates is questionable.
Regarding the scars, Dr.Birkhotltz did mention that the scarring from plating would be the similar as nailing when using the minimally invasive plate osteosynthesis technique (MIPPO). However he did mention that the timing of plate insertion would be crucial in order to avoid harming the regenerate.
Personally, I think externals is the best option for tibias since it avoids the additional trauma from nailing or plating, but if you do have time constraints and cannot wear frame for the recommended duration, then consult a surgeon who is familiar and comfortable with both nailing and plating.

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I too have always wondered why plating isn't more commonplace in CLL. If plates can bear weight immediately after lengthening, they'd give us the benefits of LON but with the safety of pure externals in terms of knee pain.

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Guys -

I found an interesting article about plating, which details various types of plating techniques in use. It specifically highlights a technique called "Locking Plating", and it's advantages over conventional compression plating.  Do give it a read if you're interested to find out more about plating.


http://www.sciencedirect.com/science/article/pii/S1877056810000587

Hope this is helpful.