PMAX femurs in June (Paley)

I humbly request to all whom it is relevant to, please let's be nice if possible?

shortbutnosmall, thank you for your questions, I enjoy all the discussion as it's helpful to generating a better outcome for myself and others I think.

Here are a couple pieces from the guide:

If you want the full guide I think they will be happy to send it if you fill out that web form on the Paley Institute website.  Ask them for the PMAX Stature Lengthening Guide.  It has a full breakdown of costs and answers a lot of questions.

"How long do we need to use
assistive devices with the 
PMAX Nail?
For the P2.2 - Most patients use crutches or a walker for
two to five months after surgery (for 8cm femurs and 5cm
tibias.). A wheelchair is needed for long distance transport.
We teach patients how to do partial weight bearing in our
physical therapy department.
For the PMAX – Patients are encouraged to use crutches or
at least one crutch or a cane to offload the bodyweight on
the lengthening limbs for as long as needed. The surgeon
and physical therapist will inform you what is appropriate
for your status."

"How much weight bearing is
allowed during lengthening?
During distraction the bone ends are held separated by the
implantable rod. This rod is secured to the bone by screws at
either end. The diameter of the rod ranges from 8.5-10.7
12.5mms. The screws have a diameter ranging from 4-5mms.
With enough repeated loading the screws of any implant will
bend or break. No implant of any make or design is immune
to this. The heavier the patient the greater this risk. This is true of
any implantable lengthening nail no matter what the material it is
made of and no matter what you are told by the manufacturer
or the surgeon.
We permit full WB when we see complete bridging of the
bone on the x-ray. At that point the bone is taking the load
and protecting the rod. During the lengthening we allow WB
using crutches or a walker and unweighting the legs using the
arms. The amount of WB allowed depends on several factors:
the weight of the patient, the diameter of the rod and the bone
being lengthened. For the largest diameter Precice2, 12.5mms,
we allow up to 75 lbs (34 kgs) on each leg. This means that
when a patient is standing on two legs with two crutches on the
ground they can take up to 150lbs or (68 kgs). However, when
walking and transferring load from one leg to the other a patient
MUST USE TWO CRUTCHES on the ground and unweight
themselves to the 75lbs (34kgs) weight with each step. Patients
must NEVER walk with one crutch during the distraction phase
no matter how much they weigh. During the consolidation phase
the same rules apply until the surgeon increases the WB quota.
To know how much WB is being done a patient can stand on a
bathroom scale till it reaches the desired e.g. 75lbs number. For
the smaller diameter rods 10.7mms and 8.5mms no more than
50lbs  (23kgs) is allowed per leg.
For a patient lengthening with the PMAX, they may walk with
walker or crutches initially until they are able to assist themselves
properly with one crutch or a cane during the distraction phase to
help offset their full body weight on their limbs. This helps to protect
the rod from bending or breakage."

PMAX can be used in tibia, but weight limits apply (from the Paley Institute stature lengthening guide):

https://postimg.cc/HVQDj3n1

Oh wow I hope they get it in turkey within 6 months of so. Been waiting so long.

Why should one do P Max if you stay crippled after 5 months post lengthening phase as It was with precise? Shouldn t It be full weight bearing? As I understand it can bear only 68 kg

Hello,
Has Paley informed you about any delay re the PMAX? I talked with a few doctors - Assayag, HSS, and Dr. D who all said that the PMAX is going to be delayed, but I was curious what Paley is saying? I'd love to book him but dont want to pay the fees and then be delayed again and again.