The 'safe' limit, who came up with it?

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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.

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Quote from: gettingtaller on May 13, 2014, 06:23:48 AMOf 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.

Gettingtaller as it appears from your response that you have already asked about safe lengthening limits prior to asking it here
for the benefit of the forum can you please post any medical sources of where lengthening your femur 9 to 10 cm is recommended as being safe
and leading to no longer term problems.

Also for your consideration from the Dr. Donghoon Lee thread

4. What are the lengthening limits for your procedures?
There are no limits to bone lengthening itself, but in reality there are limits because of soft tissues. To minimize various complications resulting from limb lengthening, it is recommended that lengthening is performed under 20% of the original bone length. 15% will be even better.
Limb lengthening is a process that involves not only the bone but also the soft tissue surrounding the bone. Especially when muscle is lengthened, even after recovery, sports ability (especially when playing vigorous sports) might not return 100%. The more the bone is lengthened, the more probability sports ability will not fully recover.
According to Park’s report (Park HW et al, JBJS,2008 ), 25% of the people who lengthen the tibia(6cm in average) was found to have some difficulties in persuing vigorous activity.
If both Tibia and Femur are lengthened sequentially, the maximum to be 10cm in total. But, one more important thing is to consider body ratio. So, I recommend to decide the target considering the safety, recovery of sports activity and body ratio.
 
http/www link edit -   http://www.limblengtheningforum.com/index.php?topic=145.0 

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Noticing 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.

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So basically lengthening 5-6cm or aroundabout the 15-20% original bone length is good? Like the recovery is not guaranteed, i understand that, but it is a pretty damn good chance you'll recover quite well with adequate care, doctor and practice? If so that is such good news because i only want to lengthen 11-12 cm, 6cm femur and 5.5 - 6cm tibiae. Does that sound like a good ratio for recovery?

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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.

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Hey gettingtaller if you don't mind me asking how old you are as your LL has
gone so smoothly I'm guessing you are 25 or under? Also what is your wingspan?

It has a big effect on how much lengthening can be done and look ok.

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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.

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gettingtaller,

did dr. b say anything about knee pain if you get to a certain point?

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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.

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Quote from: gettingtaller on May 21, 2014, 10:36:59 PMLol. 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.

Hello Gettingtaller,

it would be nice if you actually posted that x-ray. It would be quite interesting to see those 2 diffent nails.
Thank you in advance.