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Posted on Jan 20, 2021, 3:12 am
#11

Quote from: ghkid2019 on January 19, 2021, 03:05:26 AMshort term like 2 years probably 8cm femurs is better but you have to account for the fact that doing  femurs will inevitably misalign the axis of the femurs and effectively make you walk differently biomechanically and may result in arthritis. ideally 6cm femurs and 4 tibias for long term in terms of like recovery in 5-10 years+ is better for long term recovery and lifestyle. do not misunderstand doing femurs at all will mess up the axis even 1cm but less reduces that misalignment and 6 + 4 is huge amount of lenghtening no matter how one tries to twist it and you will not be the same ever. athleticism idk i feel like in the long run doing 6 + 4 is still better athletically but its just a guess.

my understanding is that in the long long term, 10 years + it is better to do quadrilaterals just because of biomechanics. short term definitely single segment.


I thought the axial deviation you are referring to has since been dismissed by Paley? I asked him during consult and he said that because of retrograde insertion techniques they are able to position nail not perfectly center in bone if you can understand what i mean--it is put in at slight angle within the intramedullary canal.

Using this technique, the otherwise previously-thought deviation of 1mm per cm lengthened (aka 8mm deviation total for full 8cm of STRYDE nail lengthening) does not occur.

BTW I'm not making any claims either way, only sharing what I was told.

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Posted on Jan 20, 2021, 3:34 am
#12

Quote from: Vibes on January 20, 2021, 03:12:31 AMI thought the axial deviation you are referring to has since been dismissed by Paley? I asked him during consult and he said that because of retrograde insertion techniques they are able to position nail not perfectly center in bone if you can understand what i mean--it is put in at slight angle within the intramedullary canal.

Using this technique, the otherwise previously-thought deviation of 1mm per cm lengthened (aka 8mm deviation total for full 8cm of STRYDE nail lengthening) does not occur.

BTW I'm not making any claims either way, only sharing what I was told.


idk but i think its possible to minimize but eventually its still gonna deviate slightly just by virtue of not being straight no matter how the nail be shoved in. im sure paley can make it drastically reduced where it esentially doesnt affect much though but there is gonna be a little which is just not ideal. and based on bone remodeling looks straight on all his xrays so it really doesnt matter how he shoves it in, the bone heals straight it appears so it gonna be deviated.

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Posted on Jan 20, 2021, 3:39 am
#13

Quote from: ghkid2019 on January 20, 2021, 03:34:13 AMidk but i think its possible to minimize but eventually its still gonna deviate slightly just by virtue of not being straight no matter how the nail be shoved in. im sure paley can make it drastically reduced where it esentially doesnt affect much though but there is gonna be a little which is just not ideal. and based on bone remodeling looks straight on all his xrays so it really doesnt matter how he shoves it in, the bone heals straight it appears so it gonna be deviated.


I agree, it doesn't make sense that it could be reduced to zero. I just hope that we can trust the top experts because if we can't even trust what Dr. Paley or Dr. Roz/etc say then who can we trust at all...

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