Thoughts about age & CLL

Edit Post

I'm sorry your GF was not so enlightened DoingItForMe. Some food for thought indeed. Double bind for us short folks. Patronised for being short but belittled for being lengthened... in the minds of the herd height equals virtue? Such conceit! The problem is social conformity. Too short? Too neurotic? Both? Q possibly. However, shamed into nothingness by the crowd, that sucks even more.

So transcend height issues quietly. “A bad conscience is easier to cope with than a bad reputation.” -Friedrich Nietzsche. I get it... thx, I think.

NB profile pic changed under advisement...

Edit Post

Thx, ortholengthening but is sustaining an open tibial shaft # really equivalent to undergoing a controlled Tibial CLL procedure? Research evidence suggesting faster healing of Femur v tibia due to tissue coverage/blood supply was accrued in trauma case series: Most tibial fractures are comminuted and open because the tibia is a subcutaneous bone & trauma injuries are high-impact, therefore more tissue disruption occurs, the vasculature may be compromised & infection is more likely. Tibial non-unions are estimated to constitute 2-10% of all tibial fractures & the incidence is greater with high-energy injuries and open fractures. However, while it is true to say that the femur has more protection relative to the tibia because of the soft tissue coverage it does not follow that cold procedures on the tibia suffer the same risk profile. That would be a non-sequitur. Also, what is the evidence for your assertion that this is even more of a problem in limb-lengthening procedures as opposed to trauma? Lastly, implant failures usually occur through the locking bolts and not through the nails so the size of the nails or the canal diameters is irrelevant. Agree that abusing a nailed leg is not a good idea though.

Edit Post

i agree that trauma vs controlled osteotomy are not same birds.
that said, nonunions and devastating wound complications can and do occur with high tibial osteotomies (which are also "cold" procedures". There is a reason why distraction for femurs are ~1 mm/day vs tibials which are more around 0.75mm/day. If you want specifics of complications and non/delayed unions you'll have to talk to the surgeons who perform them, themselves.

I can't give you evidence comparing trauma vs distraction osteogenesis. not sure if anyone has specifically looked at that. i'm just stating a personal opinion - extrapolating based on looking at bone on bone contact healing ie) closing osteotomy vs opening wedge - again realizing that it's NOT the same as distraction procedure.

yes failure is mostly at the locking screws, but one doesn't need to look to far to see broken nails. moreover, manufacturers of the nails have limitations on weightbearing based on the nail diameter.

Edit Post

For what it's worth, Dr. Paley, a veteran LL doctor, suggests doing femurs over tibias for faster recovery and better overall results.

Edit Post

Quote from: DoingItForMe on February 28, 2016, 06:31:49 PMFor what it's worth, Dr. Paley, a veteran LL doctor, suggests doing femurs over tibias for faster recovery and better overall results.

 Which is the exact opposite suggestion of Catagni... I believe that in the end, both segments are the same... Only that a specialized femur doc will tell you to go for femurs and a Tibia doc will tell you it's better to go for tibias.

Edit Post

Quote from: TIBIKE200 on February 28, 2016, 07:28:17 PM Which is the exact opposite suggestion of Catagni... I believe that in the end, both segments are the same... Only that a specialized femur doc will tell you to go for femurs and a Tibia doc will tell you it's better to go for tibias.

Dr. Paley does both femurs and tibias. But femurs lengthen at 1 mm per day while tibias are .66 mm per day. And femurs tend to get to 8 cm while tibias rarely get to 8 cm.

Edit Post

Quote from: DoingItForMe on February 28, 2016, 08:21:09 PMDr. Paley does both femurs and tibias. But femurs lengthen at 1 mm per day while tibias are .66 mm per day. And femurs tend to get to 8 cm while tibias rarely get to 8 cm.

 That's because tibias are shorter to begin with... So the muscles and soft tissue over there are not used to be as elastic as the femur's surrounding soft tissue. Although theorically, if you prepare alot by stretching the calves (Some yoga possitions) you could theorecally prepare your soft tissue for the stretch... Or as catagni put's it "A ballet dancer is not able to perform a 180 degrees leg extentions (when one leg is on the front and one in the back) on the first day... But with constant training her soft tissue will be able to do so with ease..."
  Preperation is key. And because we use out thighs muscles much more they are more prepared (and this is why everyone has duckass... Because of the Ileopsoas which is super tight because of all the sitting we do).

Edit Post

Quote from: TIBIKE200 on February 28, 2016, 08:34:26 PM That's because tibias are shorter to begin with... So the muscles and soft tissue over there are not used to be as elastic as the femur's surrounding soft tissue. Although theorically, if you prepare alot by stretching the calves (Some yoga possitions) you could theorecally prepare your soft tissue for the stretch... Or as catagni put's it "A ballet dancer is not able to perform a 180 degrees leg extentions (when one leg is on the front and one in the back) on the first day... But with constant training her soft tissue will be able to do so with ease..."
  Preperation is key. And because we use out thighs muscles much more they are more prepared (and this is why everyone has duckass... Because of the Ileopsoas which is super tight because of all the sitting we do).

theoretically maybe, but in reality preparation is not enough when doing tibias since most people require achilles tendon lengthening surgery too. catagni said so himself that 70% of his patients require it after 3-5 cm

Edit Post

Quote from: goldenegg on February 28, 2016, 10:11:34 PMtheoretically maybe, but in reality preparation is not enough when doing tibias since most people require achilles tendon lengthening surgery too. catagni said so himself that 70% of his patients require it after 3-5 cm

 I am doing alot of stretches for my claves for 2 monthes already. Huge improvment. Doing the downward facing dog position for like 30 minutes with breaks in between. Best calve's stretch

Edit Post

Agree. Thx for the insight, Ortholengthening. I'm definitely listening. I'm a sponge.