Whats your view on Dr. Mahboubian

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Quote from: Andy on October 18, 2017, 07:00:08 AMHi MirinHeight, I respect your fear for complications, but the rates for PE are really low especially for young, healthy, not obese patients like the ones who go for limb lengthening. Obviously, the decision is up to you and each one of us fights their own fears but I just wanted to say don't let fear without knowledge  guide your decisions. Best wishes.

if one develops valgus/valus deformity during ll, it can also be fixed with external fixator. These deformities (such as x legs) cannot be fixed via internal methods.

Keeping the complications in mind, external ll is best if you want to do <5cm. If you do 6+ cm, you can do internal method keeping the complications in mind, so that you wont have to wear the external fixator for 1 year+

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Quote from: MirinHeight on October 18, 2017, 07:20:08 AMif one develops valgus/valus deformity during ll, it can also be fixed with external fixator. These deformities (such as x legs) cannot be fixed via internal methods.

I think that with internal methods you don't get varus/valgus deformity in the first place. I do think externals is a valid option, no doubt.

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Problems with Traditional Internal Femur Lengthening

Internal femur lengthening devices will by their nature lengthen along the femur's anatomic axis. This can lead to shifts in the mechanical axis towards a valgus (x legs) position. Such shifts in the mechanical axis have been documented by Dr. Paley. Paley demonstrated that in normally aligned limbs, lengthening along the anatomical axis of the femur with internal Precise nails led to a lateral shift of the mechanical axis by 1 mm for each 1 cm of lengthening.

The following diagram from Paley's article demonstrates how this shift happens. Internal lengthening is compared in this picture with external lengthening, which can theoretically maintain the mechanical axis. In practice, however, we know that external monorails for femurs can lead to distortion and misalignments, as the monorail devices and pins can be subject to surgeon error and bending/warping with muscular forces and weight bearing.



Internal lengthening of the femurs is considered an ideal method of leg lengthening for most because it is fast, safe, predictable, and effective. However, this expected shift of the mechanical axis is a concern for many of us, because any degree of varus/valgus can predispose joints to arthritis. If internal femoral lengthening is then to be considered a good method of lengthening, a solution is needed to maintain the mechanical axis in normal alignment.

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One can do internal tibias to avoid any noticeable changes in mechanical axis. However, most prospective pts opt for internal femurs. Internal tibias presents with its own risks (more complicated surgery than internal femur, possible permanent knee pain due to internal reaming at the knee, PE, etc)



Thus, external tibias 5 cm is the way to go imo.

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Quote from: MirinHeight on October 13, 2017, 12:25:57 PMCliff Notes:
I have done my own research on this topic, and made some threads/messages explaining each point I make below:

intramedullary femur lengthening risks:
- fat embolism due to intramedullary reaming
- DVT; femurs having higher risk of developing DVT than tibias
- serious infection that can lead to amputation. Only infections seen in external fixator lengthening are pin-site infections

More advantages of external lengthening:
-adjustments can be made to prevent malunion, x legs, etc
-biomechanics altered a lot more when lengthening femurs

SO YEAH, ILL RATHER WEAR A CAGE FOR 6 MONTHS THAN GO UNDER A MUCH MORE INVASIVE SURGERY. To each their own.

Who's the con artist who told you six months?

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Quote from: ub40 on October 19, 2017, 02:48:34 AMWho's the con artist who told you six months?

only lengthening 3-3.5 cm..

of course if you lengthen 5 cm, it will be around 10 months