Walking immediately after lengthening phase!

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Internal femur is safer than external tibia or femur in almost every aspect

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Quote from: LLSouthAmerica on May 29, 2017, 02:23:33 AMInternal femur is safer than external tibia or femur in almost every aspect

Is more comfortable, but for example if there is a misalignment, can you correct if with precice inside? But if you have Ilizarov frames It can be corrected, also Internal tibias or femurs are bloody surgeries, fat emb is almost impossible in an Ilizarov procedure.

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Quote from: onemorefoot on May 29, 2017, 04:23:50 AMIs more comfortable, but for example if there is a misalignment, can you correct if with precice inside? But if you have Ilizarov frames It can be corrected, also Internal tibias or femurs are bloody surgeries, fat emb is almost impossible in an Ilizarov procedure.

tibia is more complex and weaker bone than femur. You need to cut two bones, x leg and most complications come from tibia. If i don't have money for internal then i will not risk my life with this risky surgery. You want to lie to yourself but face the truth. All experts and top docs prefer internal femur, AS Guichet said if there is cars why riding horses? 

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Quote from: The Kaiser on May 29, 2017, 01:36:44 PMtibia is more complex and weaker bone than femur. You need to cut two bones, x leg and most complications come from tibia. If i don't have money for internal then i will not risk my life with this risky surgery. You want to lie to yourself but face the truth. All experts and top docs prefer internal femur, AS Guichet said if there is cars why riding horses? 

Then I dont know, but yes cars are more comfortable.

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Tibias with an external stable device like a hexapod and not too much lengthening is the less risky way to do LL and leads to the less long term effects.

Less risky surgery than drilling through the bone, less chances of non alignment, misalignment can be fixed, it is weight bearing and the cheapest method.
The only drawback (major one) is patient's comfort but in everything else is superior.

Internal nails in femurs is a good way but you need two major surgeries to put and remove the nail, it can cause non alignments (especially albizzia nails like Guichet's and Betz's), best nails are non fully weight bearable, are very pricely and finally femur lengthening most of the times is not as good looking as tibia lengthening and many studies say that inevitably causes knee arthritis (which I can't say for sure.of course).

So, whatever top doctors say (as puting a nail needs less experience than puting an Ilizarov device and they can earn much more money than doing externals as internals are far more expensive and they earn money from the manufacturers too), external tibias with a good frame and a sensible lengthening is the best way of LL with the best long term outcomes.
If I needed only one LL, regardless of money I would have done again external tibias but with taylor frames and 6cm lengthening.

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Body B, do you know how long is an Ilizarov surgery, 2 hours? Another advantage, becuase femur surgery lasts 4 or more hours.

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External only is very bad idea. Because you have to stay with the fixator a lot of time. For 6cm more than 1 year.
I had my surgery my first leg in 18th on february and the second in july. And in 8 on november i started to study one course.
Nobody suspect nothing.

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Externals only in tibias is a much better idea than LATN or LON because of an increased risk of infection and also the possibility of permanent knee pain due to the insertion of the nail. Internal tibias also has the same issue with insertion of the nail and also that healing is very slow. The best option to do tibias is as Body Builder said an external stable device and stay the whole period in frames that is to say for a 6 cm lengthening around 11 months (1.5- 2 months per cm of gain)

All in all, lengthening tibias is worse than lenghtening femurs, because there are 2 bones involved, there is worse healing, and the soft tissue is less compliant than in femurs so it tolerates less gain. There is a mechanical reason why the femurs are longer than tibias and sometimes this is altered by the lengthening. There is a risk of knee pain if you alterate the proportion of femur/tibia too much.

External methods are worse than internal because of several reasons and that's why top doctors prefer internal. Overall, there is a lot of pin tract infections (there is on average 1 to 2 infections per patient) which could be severe. Remember the skin is the first barrier against infections and this is altered. Also there is more joint stiffness and contractures. It is also less tolerable and it brings worse cosmetic results.

The best combination is internal femurs and lengthen a conservative amount and the risk of misalignment would be small. Second best is pure external tibia.

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I did internal tibias and i don't have any pain in my knees.

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Good for you paco1, how much did you lengthen and how long did it take you to full consolidation? As I said there is a bigger risk and a real possibility, but that does not mean you inevitably get knee pain.

For example there are patients from third world countries who lengthen 6-7-8 cm without major issues but I still wouldn't recommend going there.