I haven't seen that many posts that go into detail on this, however these are the two most popular options among internal nails.
It seems like an obvious decision to me when not considering money and the inconveniences associated with manual clicking vs magnetic.
All of the benefits of a weight-bearing nail (significantly faster recovery during/post-consolidation, better rehab, more self sufficiency during lengthening).
Am I missing something here? What's the catch? Some people suggest nail reversal being an issue, but non-union risk doesn't seem to be great with the femur, especially with younger patients.
Seriously, femur G-nail or Precise? Why is it not obvious?
Gnail is a bit more expensive. There's the non-union risk as mentioned, and the clicking can be painful until you get the hang of it as I know from experience.
Weigh that up against the benefits you've spoke of. I also think another benefit is you can lengthen more on gnail whereas precise stops at 8cm, although of course that isn't a benefit for everyone, only those who want to lengthen above accepted safe limits.
It's obvious that you haven't done CLL, or your research. Let me help you a little.
- Go to Victor's youtube channel (cyborg4life) which contains answers to probably 300% of the questions repeatedly asked on this forum. He has a video on this called Battle of the Nails with 3 world class doctors. They all talk about why Precice is superior to any nail out there.
- Here's where it becomes really obvious that you haven't done your research or CLL, because if you had, you would know that 1) this surgery is PAINFUL, and 2) clicking that many times a day becomes VERY painful. When your leg is broken, you can barely move it initially. Contorting it so it clicks 20 whatever times a day??? Absolutely not. Props to those who do it, seriously, on top of the already existing pain.
- The more important factor: weight bearing nails are stiffer and are more prone to non-union
- The ABSOLUTE MOST important factor: the ability to go in reverse. It's funny that no one thinks about this, and I've talked to multiple people where this was key to lengthening, and one whose limbs this saved. The reason why CLL exploded when STRYDE nail was released was because it had all the features of Precice AND was weight bearing, not because it was the first weight bearing nail (it wasn't).
This procedure isn't just about fully weight bearing. It's all that noobs think about, myself included, before I did 5 years of homework prior to pulling the trigger. This procedure is about having as little pain and as much comfort as possible, finishing without complications, and if you do have complications, having the ability to eliminate them so you can have a successful outcome (walking again).
Cyborg4Life recently talked about this in one of his live videoes, where he recommended to stay in the safe range between 6-7 cm on the femurs, cuz most people who do more don't fully recover or get's limited Range of motion. So the benefit of going over 8 cm is maybe an advantage for 5% of people doing this surgery, and has a laughable starting height of above 175+ cm
- 29:20
I'm personally sticking with precice even tho it ain't weightbearing, for these reasons:
1. it's fda approved and used all over the world, which isn't the case for the other nails mentioned.
2. They have the reverse future if a non union should happen (unlikely in the femur, but still).
3. According to dr. G the pain level with doing G-nail /betzbone is about 30% higher than with precice (the surgery is already painful with precice...)
4. Precice is cheaper and according to most surgeons like mahbouhian, Dr lee, etc better...
5. the lengthening mechanism is wireless and magnetic which makes it alot easier with precice than clicking with Gnail /betzbone which can be troublesome according to many diarys on this forum.
Quote from: DanishViking on April 26, 2023, 09:37:39 AMCyborg4Life recently talked about this in one of his live videoes, where he recommended to stay in the safe range between 6-7 cm on the femurs, cuz most people who do more don't fully recover or get's limited Range of motion. So the benefit of going over 8 cm is maybe an advantage for 5% of people doing this surgery, and has a laughable starting height of above 175+ cm
Nah I don't agree with this, mainly because not everyone cares about a 'full recovery'.
For instance right, so long as I can walk after surgery, climb the stairs and don't have any lingering pain, I'd consider that fully acceptable. I'd 100% make the trade of 'never playing sports again' for an extra couple of centimetres height, mainly cos I haven't played sports in about 15 years anyway. Most people only use their legs for walking and aren't interested in squatting or running marathons, and so don't need anything like '100% recovery'.
8cm and no sports/heavy leg workouts absolutely mogs 6cm and 'I can play sports and do incel lifts like squatting' for the vast majority.
Quote from: p00293 on April 26, 2023, 10:00:07 AMNah I don't agree with this, mainly because not everyone cares about a 'full recovery'.
For instance right, so long as I can walk after surgery, climb the stairs and don't have any lingering pain, I'd consider that fully acceptable. I'd 100% make the trade of 'never playing sports again' for an extra couple of centimetres height, mainly cos I haven't played sports in about 15 years anyway. Most people only use their legs for walking and aren't interested in squatting or running marathons, and so don't need anything like '100% recovery'.
8cm and no sports/heavy leg workouts absolutely mogs 6cm and 'I can play sports and do incel lifts like squatting' for the vast majority.
I agree.
It depends on Your Job too, I work on machinery that requires me to squat and lie and get up off the floor, I struggled with these things for a year after CLL.
QuoteNah I don't agree with this, mainly because not everyone cares about a 'full recovery'.
For instance right, so long as I can walk after surgery, climb the stairs and don't have any lingering pain, I'd consider that fully acceptable. I'd 100% make the trade of 'never playing sports again' for an extra couple of centimetres height, mainly cos I haven't played sports in about 15 years anyway. Most people only use their legs for walking and aren't interested in squatting or running marathons, and so don't need anything like '100% recovery'.
8cm and no sports/heavy leg workouts absolutely mogs 6cm and 'I can play sports and do incel lifts like squatting' for the vast majority.
Once you have the surgery you will very quickly change your mind about having a full recovery. Moreover, though, the person that cares about a full recovery and insists on it is your surgeon. The have an ethical code and a reputation to uphold. Well, most doctors anyway. Feel free to tell any prospective LL surgeon that you don't care about a full recovery and see if they'll operate on you. You'll find yourself out the door pretty quickly.
Recovering from LL isn't just about squatting, sports, etc. It's about not having chronic pain, regaining ROM, flexibility, healthy bone growth, and of course walking normally with the same or better gait. The Dr's and patient's goals should be symbiotically aligned to get you to recover with those parameters in mind. Otherwise Dr.s' wouldn't bother working with you with x rays every 3 weeks, follow-ups, protocol, PT, stretching and sleep regimen, supplements and so on. They'd just operate and leave you to your own devices.
I just took my 4th set of X-rays, have amazing bone growth, zero hardware damage, no pain when I sleep (nerve pain is gone), zero pain when I lengthen, still flexible, and am projected to make a full recovery without any complications. My PT tells me I'll be able to regain my original flexibility and ROM. All this is because I'm diligent with every single protocol prescribed by Dr. Rozbruch. And I don't want to be. I weigh 150 lbs and have the 12.5 mm rods. I could theoretically fully weight bear. I begged him to let me. He wouldn't. He told me that walking now is nowhere near as important as recovering to same as before, but being 3.2 inches taller.
That's the result you want. Don't be short-sighted in your approach. You can have both. What you want during CLL is the best Dr. possible and the best nail possible, both to get you through what will be one of the toughest times of your life with as little pain as possible, and maximizing your chances of coming out of this as close to 100% as you can. From a nail perspective, nothing comes close to Precice as of now. Supposedly a full weight bearing version of Stryde will hit the market again eventually, and I think that's when CLL will go mainstream, though it's slowly but surely gaining steam and getting there.
Quote from: uponly on April 26, 2023, 08:23:59 PMOnce you have the surgery you will very quickly change your mind about having a full recovery. Moreover, though, the person that cares about a full recovery and insists on it is your surgeon. The have an ethical code and a reputation to uphold. Well, most doctors anyway. Feel free to tell any prospective LL surgeon that you don't care about a full recovery and see if they'll operate on you. You'll find yourself out the door pretty quickly.
Recovering from LL isn't just about squatting, sports, etc. It's about not having chronic pain, regaining ROM, flexibility, healthy bone growth, and of course walking normally with the same or better gait. The Dr's and patient's goals should be symbiotically aligned to get you to recover with those parameters in mind. Otherwise Dr.s' wouldn't bother working with you with x rays every 3 weeks, follow-ups, protocol, PT, stretching and sleep regimen, supplements and so on. They'd just operate and leave you to your own devices.
I just took my 4th set of X-rays, have amazing bone growth, zero hardware damage, no pain when I sleep (nerve pain is gone), zero pain when I lengthen, still flexible, and am projected to make a full recovery without any complications. My PT tells me I'll be able to regain my original flexibility and ROM. All this is because I'm diligent with every single protocol prescribed by Dr. Rozbruch. And I don't want to be. I weigh 150 lbs and have the 12.5 mm rods. I could theoretically fully weight bear. I begged him to let me. He wouldn't. He told me that walking now is nowhere near as important as recovering to same as before, but being 3.2 inches taller.
That's the result you want. Don't be short-sighted in your approach. You can have both. What you want during CLL is the best Dr. possible and the best nail possible, both to get you through what will be one of the toughest times of your life with as little pain as possible, and maximizing your chances of coming out of this as close to 100% as you can. From a nail perspective, nothing comes close to Precice as of now. Supposedly a full weight bearing version of Stryde will hit the market again eventually, and I think that's when CLL will go mainstream, though it's slowly but surely gaining steam and getting there.
Had the surgery, lengthening now so knock it off with the condescending tone.
The things you cite are exactly the same as mine (ROM and no chronic pain). You need to be able to walk, climb the stairs, and not be in pain, but that's it.
I'm quite sure many surgeons perform this surgery knowing it's unlikely the patient will be running marathons. Seems a wierd conversation to have with a surgeon but of course you're not going to bring up something like that. The fact remains, 95% of the population use their legs for walking and that's about it. No one needs to be able to do incel lifts like squats. No one needs to be able to run fast. Being taller is of much more benefit than being able to do that garbage.
Never said you shouldn't follow the doctors protocols, but you boys love your strawman arguments. Precise vs other nails could be debated till the cows come home, it's obviously not that clear cut as Precise doesn't have a monopoly on CLL nails. Non weight bearing is a huge disadvantage (and yes, the now matters every bit as much as the future, and if you're doing CLL, in the moment your experience will be much worse if you can't bear weight). The gnail/betzbone can't reverse, is more expensive, and clicking can be painful. LON tibia is cheaper but usually you'll get less height, have scars, and higher risk of complications. Pick your poison but don't act like it's a slam dunk win for any.
QuoteHad the surgery, lengthening now so knock it off with the condescending tone.
The things you cite are exactly the same as mine (ROM and no chronic pain). You need to be able to walk, climb the stairs, and not be in pain, but that's it.
I'm quite sure many surgeons perform this surgery knowing it's unlikely the patient will be running marathons. Seems a wierd conversation to have with a surgeon but of course you're not going to bring up something like that. The fact remains, 95% of the population use their legs for walking and that's about it. No one needs to be able to do incel lifts like squats. No one needs to be able to run fast. Being taller is of much more benefit than being able to do that garbage.
Never said you shouldn't follow the doctors protocols, but you boys love your strawman arguments. Precise vs other nails could be debated till the cows come home, it's obviously not that clear cut as Precise doesn't have a monopoly on CLL nails. Non weight bearing is a huge disadvantage (and yes, the now matters every bit as much as the future, and if you're doing CLL, in the moment your experience will be much worse if you can't bear weight). The gnail/betzbone can't reverse, is more expensive, and clicking can be painful. LON tibia is cheaper but usually you'll get less height, have scars, and higher risk of complications. Pick your poison but don't act like it's a slam dunk win for any.
It's pretty clear cut. Many doctors and experts have spoken on this, on the record. When Paley, Rozbruch, Thaller, Lee, Gdalevitch, Assayag, Mahnoubian, etc. endorse another nail, and the FDA approves one, please feel free to come back and comment.
But hey, you tell yourself whatever you want to reinforce your deluded thinking. Good luck with your recovery.
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