I discussed this topic with a LL patient who did LON and agree to share his views about the additional risks of LON/LATN.
Updated with more information.
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" feel free to share more of my experiences if it helps others post it. it could be one of those things that can save future LL patients from or at the very least minimize their risks associated with internal methods.
LON, when performed correctly, with proper fixation of both bones (Tibs and fibs) at the Proximal, Medial, and distal ends and if high proximal tibia osteomy is avoided (can also lead to malalighnment according to my docs - actually there's some articles or vids available as well such as this one:
http://www.wheelessonline.com/ortho/im_nailing_of_proximal_tibial_fractures.)
the risk of knee pain is not worth it. It's very, very, very annoying. And sometimes debilitating. Some days the are mild, other days the are more severe. I would recommend you stay the hell away from any internal tibia methods.
Before this site, I did not even know about the risks associated with Internal nailing for Tibias because those fkers on old forum downplayed everything. And whenever someone did bring that concern up, it was quickly shot down or censored such as the one brought up by a patient from Dr. Paley I believe. Who knows, maybe scum bags like Apo and Tall have persistent knee and hip pain but are not telling us so they can continue their marketing to naive people.
I am not sure why the knee pains happens. Some Docs say it is because of weak quad muscles, others mention damage to the infrapettelar nerve branch of the sapheous nerve. Others mention damage to the fat pad on the knee, or the lateral retraction of the petella tendon. Others mention damage on the patella tendon itself from either the splitting process, OR the other method of just moving it.
if I could redo my experience again, I would definitely, without a doubt, choose Externals only. I don't care about waiting in the frames for an extra 4-5, 6 months, 1 yr, I don't care. At least with externals only, I would have avoided the knee pain issues, AND able to do precise deformity correction to correct malalighnment associated with Lengthening.
My legs would be totally straight, bones perfect anatomically aligned. No knee pains, no extra trauma from Nail insertion, less scars associated with the Nail insertion etc.
And most importantly, what I've noticed is that people who op with LON or LATN are people who think they are saving time by not being in frames for a few extra months. But from what I've witness and learned from prior patients and from myself, is that even though you don't have the frames on, you are still suffering and basically semi-disabled because you still are experiencing pain, muscle contracture, nerve damage, bone migration from improper fixation, malalighnment, and IM Nail trauma and the requirement to remove it later on.
So I would choose to be in frames and suffer for 9-12 months, and then be done with LL forever. Rather then be free by taking the easier way out (by removing frames early and putting in internal rod or plate) and be stuck in a state of purgatory because of complications and having to wait longer before your journey is complete (2-3 years or more).
If you want, and waiting is out of the questions, LATP is also viable options if waiting is 100% out of the questions. From my experience, and other patients, I noticed that the more cuts and the more invasive a surgery is, the higher risk of developing nerve problems like potentially permanent numbness, or tenderness and nerve sensitivity from the cutting, insertion, and trauma. "
Humans cannot "fully Regenerate" like other animals. They can only "heal" where it is NOT 100% like it was prior to injury. Humans tissues repair itself and leave scar tissue behind which can cause interference with other tissues. Scar tissues are unsitely, and for all intensive purpose, cannot be completely, 100% removed - only the appearance to be improve.
And scar tissues are not like the surrounding tissues in that they do not have nerves etc in them, so yes, the area on the scar is numb.
One more thing regarding Externals, and it is pretty a flook or just semi-dumb luck: There is an issue with compartment Sydrome and nerve damage, especially with Internal methods. Externals have pins and wires going through your legs which provides "vents" to help minimize / release pressure.
Internals do not. I know this because a Doctor who wants to fix me up gave me ways in which he would fix me. The internal method method all required fasocitomy and decompression, whereas, the externals only did not.
