People talk about 6cm being the safe limit for femurs. I'm already way past that and I've met lots of other betz patients who have passed that and have or are having a good recovery. So where does this safe limit originate? Do the surgeons who advise this do it because their nails or techniques do not allow them to go much beyond that? Is it their insurance companies telling them to say this to cover their asses against future liability claims? Are there documented cases of really bad things happening? Fwiw I got minor nerve damage beneath my knee at 5cm, since then everything has been fine. I'm at 8cm and could easily go more (my body isn't freaking out). I hear people on this forum refer to it as though it's some kind of gospel thus perpetuating this (what could be) a theoretical or "finger in the air" safe limit. Just wanted to hear what people think.
Quote from: theuprising on May 11, 2014, 09:56:36 PMGettingtaller want to know why you are asking now and not before you started lengthening?
Uprising, why do you assume I didn't??
Quote from: theuprising on May 12, 2014, 10:40:42 PMObviously since you are already way past the recommended limit. Second obvious one
is that you made this thread.
My thinking was exactly like yours when I first found LL wanting to do the maximum amount
and finding a surgeon who would do it. The more I researched you realise that just because
something can be done doesn't mean it should. This being said good luck with recovery if
you had a tall enough starting height you should have a better time of it.
Of course I asked before lengthening, your question was just bizarre. You'd be brain dead if you didn't.
This is a forum of people with a shared interest and I'm curious about what the LL collective thinks about this.
Quote from: theuprising on May 18, 2014, 11:15:19 AMNoticing you asked about safe lengthening in the Birkholtz thread he had already answered your question on Page 16.
Question asked by handy
Dr. Birkholtz- Why would lengthening 5-6cm be any safer than 6.1-8cm in terms of only malalignment? If lengthening along the anatomic axis with internal nails causes malalignment, since you're not lengthening along the mechanical axis, wouldn't any amount of lengthening then cause malalignment? What is it about lengthening 5-6cm and malalignment that makes it any safer than 6.1-8cm if all internal lengthening causes malalignment?
Birkholtz reply:
You are right. ANY lengthening along the anatomic axis will cause malalignment. As with most things in life, it is the magnitude that counts. Smaller distances will cause smaller malalignments and larger distances may lead to significant malalignments.
Which is why it keeps being stated on here that the more you lengthen along the anatomic axis (femurs) the larger your malalignment is and the more likely problems will be down the track. Not that you will definately get them but you are more likely to than someone who lengthened a more sensible distance.
Thanks uprising. This isn't very clear to me however. Reduced function I kinda get but the good dr doesn't really go into specific examples of problems. From the consultations I had before my surgery, it came down to how much your body could stretch during lengthening before it gave up or you fell over from intolerance. The other consideration was cosmetic proportion. I'm not so naive to think that changing something like this isn't going to have an impact but going from 6cm to 9cm? What more damage are you actually doing? I've met some patients that went to 9 or 10 who came back for nail removal and they appeared to be doing just fine. You wouldn't think they'd had LL. Both betz and guichet advocate long lengthening as long as your body can handle it e.g. Your IT bands don't go to hell leaving you looking like John Wayne. As I write I'm at 8.7 on my left leg so will hopefully stop clicking it in 3 days...so far (touch wood) I can say it's not been as hard as I was expecting, maybe this is the big difference between internals and externals.
Lol. I started my ll at 39 and turned 40 a month into it. I have amazing bone consolidation too. Betz nearly fell off his chair when he saw how much bone cloud I had 
I'll upload an X-ray tomorrow.
He said it's very likely after 8cm and I have if now but only at night when my leg is jb the sane position for too long. It's temporary. Goes away after you stop clicking and your body adjusts. Takes about a week after clicking.
Kinda busy with family at the money but will upload when I get back in front of a pc.
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