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Posted on Nov 26, 2013, 4:03 pm
#1
Let me hijack this post for a sec to ask all of veteran LLers and prospective LLers with lots o knowledge. Of the three economical methods namely LON LATN and MONORAIL, which one of these is the best way to go?

This is my understand of these methods:
LON - cut back time, but risk of nail infection also since one begins with the intramedullary nail your bone will not come back as strong. Then you have to get another operation to remove nails.
LATN - save time but need extra 2 opertions, after lengthening and removal of nails. Lengthening period with external only.
Monorail - no bulky frames, no correction while lengthening (unless I'm wrong), consolidation period times 2 of lengthening period. The good thing is, no need for extra surgery to remove nails.

Please help add on or deduct pros and cons so I can pick a method to suit my needs.

* Above Post moved from Disobedient's diary, easier to track replies with a new thread.
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Posted on Nov 26, 2013, 5:15 pm
#2
You can also get Ilizarov without internals in Russia, so monorail is not your only option for external-only.

LON and LATN are almost exactly the same.  So close I'd barely consider them different LL methods.  Both involve 3 surgeries.  The only difference is with LON, the 1st surgery is really big with 2 smaller surgeries later, and LATN has two big surgeries and one smaller surgery later.  You will get the same result with either of them.

Pick the right doctor first and just go with whatever method he uses.
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Posted on Nov 26, 2013, 6:26 pm
#3
An advantage I see with LATN over LON is that the intramedullary nail put inside after lengthening can be of a larger diameter than the one put inside the bone canal during lengthening with LON. I know Dr. Rozbruch published something saying that LATN has a shorter recovery time compared to LON or external also.
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Posted on Nov 26, 2013, 8:30 pm
#4
Thank you MDW and Kilokahn for weighing in.
 
I forgot to include the original Ilizarov which probably really safe but time in bulky frames after lengthening can be exhausting for anyone to bear especially in our time, also the cheapest from what I've heard.

Lately I've heard so many bad things regard Monorail, such as, one can not bear weight for the entire lengthening period but the weight bearing is allowed once the lengthening period is over. I don't like the hassle of getting extra surgery, I just might join Disobedient in India (Diso if you're reading this let me know what you think).

I also heard bad things about LON, like deep nail infections and bent nails.

Although I have not heard much bad things about LATN but finding a doctor who willing to perform this method is rare and patient who had undergo this method is rarer.

Guys, if you have to choose one method and let say all methods are available, which method would you choose? Give additional proves and evidences or story you have heard at least.

Thank you.
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Posted on Nov 26, 2013, 9:05 pm
#5
External only was my first choice.  Least invasive, least traumatic, fastest to completely finish.

If you really want LATN but can't find a doctor you might ask a LON doctor to do it.
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Posted on Nov 26, 2013, 9:22 pm
#6
LATN for me.

I wouldn't be able to stand being in frames for so long with purely external methods, even though they're the cheapest. I want to go for 5cm on my tibias, and most orthopedic surgeons say adults need up to 2 months in frames per centimeter lengthened. That means a potential 10 months or longer wearing the Ilizarov fixators. To hell with that.
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Posted on Nov 26, 2013, 9:47 pm
#7
I think external only would be my preference as well.  Once you're done, you're done!  No drilling or reaming into your bones, etc.  But the frames are going to be on for a very long time which is the only thing holding me back from doing that on my tibias.  Who knows, when I finally come around to it, that may be my ultimate choice.
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Posted on Nov 26, 2013, 10:05 pm
#8
Thanks guys. Any suggestion if I joined Disobedient? She's doing quad with Monorail, I'm just interested in 2 for tibias.

Btw, how can I pm Disobedient? I'm serious about LL now, this is my year.
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Posted on Nov 26, 2013, 10:12 pm
#9
My suggestion is not to join her.
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Posted on Nov 26, 2013, 10:14 pm
#10
Quote from: BullSurfer on November 26, 2013, 10:05:46 PM
Thanks guys. Any suggestion if I joined Disobedient? She's doing quad with Monorail, I'm just interested in 2 for tibias.

Btw, how can I pm Disobedient? I'm serious about LL now, this is my year.

There's a white balloon under every user's username (or avatar if they have one) that you click on and it will take you to the message box to write that specific person a PM.

As far as joining Disobedient, I'm not sure that's the best idea (imo). Most qualified orthopedic surgeons would not even agree to do external only quadrilateral lengthening with monorail fixators. It's that dangerous. Yet her doctor did it anyway. Probably not a doctor you would want doing your surgery. If it were me, I'd look for other options. If you plan on going ahead with it, be very very careful and don't let the doctor ignore potential complications.
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Posted on Nov 26, 2013, 10:41 pm
#11
I'm here to learn more so I can make proper decision so that I don't go into LL blindly. Disobedient seems fine to me, why hasn't she posted some news.

Ok guys, are suggestion on Dr. choice? I'm willing to listen if you're in India and have heard or consulted with some reputable doctors. If I'm rich I would do the internal nail or at least with Rozbruch since he's close to where I live. But karma dealt me a short hand, I'm gonna make do with what I can.
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Posted on Nov 26, 2013, 10:43 pm
#12
Quote from: BullSurfer on November 26, 2013, 10:41:58 PM
I'm here to learn more so I can make proper decision so that I don't go into LL blindly. Disobedient seems fine to me, why hasn't she posted some news.

Ok guys, are suggestion on Dr. choice? I'm willing to listen if you're in India and have heard or consulted with some reputable doctors. If I'm rich I would do the internal nail or at least with Rozbruch since he's close to where I live. But karma dealt me a short hand, I'm gonna make do with what I can.

Is India your only option? How much money have you saved up?
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Posted on Nov 26, 2013, 10:47 pm
#13
Quote from: Kilokahn on November 26, 2013, 10:43:25 PM
Is India your only option? How much money have you saved up?
[/quote

Yes, at the moment.]
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Posted on Dec 2, 2013, 12:10 am
#14
Quote from: BullSurfer on November 26, 2013, 08:30:26 PM
(Diso if you're reading this let me know what you think).
 

I said it before I can't recommend my Dr till I see the final result..
but so far I'm doing well...
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Posted on Apr 13, 2014, 3:07 am
#15
Getting the external device off the legs after 3-4 months sounds alot more appealing than 9-10 months. 

It is often said that doing just one surgery with external device is less invasive than LON/LATN,  but how much difference does it ultimately make to full recovery of a normal condition? 

So  my question is this:  Which method give the best possibility of full recovery to previous sporting and functional abilities?  Please give your thoughts, thank you.

I'm thinking about doing Monorails because of the possible knee pain problem with LON/LATN mentioned in another thread here 
http://www.limblengtheningforum.com/index.php?topic=342.0
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Posted on Apr 13, 2014, 10:12 am
#16
Quote from: jerry on April 13, 2014, 03:07:11 AM
Getting the external device off the legs after 3-4 months sounds alot more appealing than 9-10 months. 

It is often said that doing just one surgery with external device is less invasive than LON/LATN,  but how much difference does it ultimately make to full recovery of a normal condition? 

So  my question is this:  Which method give the best possibility of full recovery to previous sporting and functional abilities?  Please give your thoughts, thank you.

I'm thinking about doing Monorails because of the possible knee pain problem with LON/LATN mentioned in another thread here 
http://www.limblengtheningforum.com/index.php?topic=342.0

External only definitely has the best possibility of full recovery, its the least invasive. Particulary the knee pain problems you mention seem to be quite common with internal methods.
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Posted on Apr 13, 2014, 10:36 am
#17
I agree with Kilokahn. There's no sense to do externals if you can afford LON/LATN. Frames around your legs for 8-9 months? Forget about it, I'd never do that.

When saying this, I'm assuming that someone who asks "Intramedullary methods or external ilizarov?" is able to afford LON/LATN.

I did internals, I do have a little knee pain here and there. Who cares when you're taller?
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Posted on Apr 13, 2014, 11:02 am
#18
There is a good reason NOT to do internals for tibia LL. KNEE PAIN.

with external only, you are on frames for an additional 5-6 months.

surely that is better than having knee pain for the rest of your life. pain wears you down. it ages you faster so avoid it if you can.

I am not doing my tibia until methods improve or I can afford (time wise) to do external only. I am seriously considering the salmefix.

The best option atm is internal femur.
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Posted on Apr 13, 2014, 11:29 am
#19
There is the option of LATP which reduces the external fixation time and avoids the insertion of an IM rod, therefore no risk of permanent knee pain.
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Posted on Apr 13, 2014, 11:55 am
#20
I'll ask my doctor about this tibiae LON knee pain. I wonder what Dr.Franz thinks about this? Maybe he could give us an insight.
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