Re: LON, LATN and MONORAIL

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.

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.

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.

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.

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.

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.

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.

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.

My suggestion is not to join her.

Quote from: BullSurfer on November 26, 2013, 10:05:46 PMThanks 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.