Limb Lengthening Forum

Limb Lengthening Surgery => Limb Lengthening Discussions => Topic started by: Stadiometer on September 04, 2016, 03:43:54 PM

Title: Dr. Paley's New Internal Lengthening Nail..Full Weight Bearing (Almost)
Post by: Stadiometer on September 04, 2016, 03:43:54 PM
(http://i1296.photobucket.com/albums/ag19/Stadiometer/Email%201_zpsj2opwsvi.png)

(http://i1296.photobucket.com/albums/ag19/Stadiometer/Screen%20Shot%202016-09-04%20at%2010.11.08%20AM_zpsu0a8p7fx.png)

(http://i1296.photobucket.com/albums/ag19/Stadiometer/Screen%20Shot%202016-09-04%20at%2010.11.38%20AM_zps3l0pdv5n.png)

(http://i1296.photobucket.com/albums/ag19/Stadiometer/Screen%20Shot%202016-09-04%20at%2010.13.54%20AM_zpss96h5b1q.png)

(http://i1296.photobucket.com/albums/ag19/Stadiometer/Screen%20Shot%202016-09-04%20at%2010.12.00%20AM_zpsmrbq91ol.png)

(http://i1296.photobucket.com/albums/ag19/Stadiometer/Screen%20Shot%202016-09-04%20at%2010.14.29%20AM_zps16s4plih.png)
Title: Re: Dr. Paley's New Internal Lengthening Nail
Post by: YourSpaceBoyfriend on September 04, 2016, 03:55:39 PM
I wonder if the nail will be available for the other doctors except Paley.
Title: Re: Dr. Paley's New Internal Lengthening Nail..Full Weight Bearing (Almost)
Post by: Alu on September 04, 2016, 04:05:56 PM
When exactly did you ask for this sort of information?
Title: Re: Dr. Paley's New Internal Lengthening Nail..Full Weight Bearing (Almost)
Post by: Stadiometer on September 04, 2016, 04:14:37 PM
I wonder if the nail will be available for the other doctors except Paley.

I would be surprised if the process doesn't play out similar to the release of PRECICE 1&2.

When exactly did you ask for this sort of information?

The above email exchange was conducted over the last 72 hours.
Title: Re: Dr. Paley's New Internal Lengthening Nail..Full Weight Bearing (Almost)
Post by: Nightwish on September 04, 2016, 06:14:17 PM
Damn. If Dr Franz has this and is around the same priceish... it's not even going to be a choice really for me.
Title: Re: Dr. Paley's New Internal Lengthening Nail..Full Weight Bearing (Almost)
Post by: onemorefoot on September 04, 2016, 07:48:24 PM
Do your think that it will be as different in cost as PRECICE 1 and PRECICE 2.
Title: Re: Dr. Paley's New Internal Lengthening Nail..Full Weight Bearing (Almost)
Post by: jbc on September 04, 2016, 08:56:19 PM
SWEET!! That fits my timeline for the surgery. I'll even wait a few months to use the new nail.

Also - cobalt chrome - this is what Dr. Paley said the Guichet nail was made of during my consult with him. That's the material I could not remember :).
Title: Re: Dr. Paley's New Internal Lengthening Nail..Full Weight Bearing (Almost)
Post by: YourSpaceBoyfriend on September 04, 2016, 09:36:09 PM
So it will be basically a guichet nail but without cringy clicks? That's sweet.

I just hope they will reduce cost of the nail, internals are still ridiculously expensive comparing to the external frame.

A man can hope.
Title: Re: Dr. Paley's New Internal Lengthening Nail..Full Weight Bearing (Almost)
Post by: Mtall on September 04, 2016, 11:03:44 PM
Will this mean that the Precice 2 will go off the market, or will it still be available?
The reason I'm asking is that, I'm only around 55 kgs at the moment, so if the new nail's only advantage is further weight bearing, I don't need it.

Title: Re: Dr. Paley's New Internal Lengthening Nail..Full Weight Bearing (Almost)
Post by: Mtall on September 04, 2016, 11:05:07 PM
So it will be basically a guichet nail but without cringy clicks? That's sweet.


So I take it that in comparison to the Guichet nail, Precice 2 comes with no clicking pains?
Title: Re: Dr. Paley's New Internal Lengthening Nail..Full Weight Bearing (Almost)
Post by: Penguinn on September 05, 2016, 01:48:17 AM
Wonder how much it'll cost.
Title: Re: Dr. Paley's New Internal Lengthening Nail..Full Weight Bearing (Almost)
Post by: onemorefoot on September 05, 2016, 03:47:53 AM
I dont think the difference in cost will be huge like precice 1 and 2, because this is 2 yet.
Title: PRECICE 3.0 - Cobalt Chrome - Full Weight Bearing Nail (Crutches) - Delayed
Post by: Stadiometer on November 15, 2016, 11:30:06 PM
(http://i1296.photobucket.com/albums/ag19/Stadiometer/Screen%20Shot%202016-11-15%20at%201.42.51%20PM_zps7zxqclgq.png)
Email received less than 24 hours ago


Ellipse Technologies the maker of PRECICE was recently acquired by NuVasive:
http://ellipse-tech.com
http://www.nuvasive.com

Dr. Paley has developed a new surgical technique whereby he also inserts a rod inside the fibula, and not just inside the tibia, when a patient is undergoing tibia lengthening. Thank you to Iamready for bringing this to the forum's attention.

Internal tibia lengthening is inherently much more dangerous than internal femur lengthening. Patients developing subluxation and arthritis of the ankle with the surgical technique of Dr. Betz and Dr. Mahboubian have been covered in the following threads:

Dr. Betz: http://www.limblengtheningforum.com/index.php?topic=380.0
Dr. Mahboubian: http://www.limblengtheningforum.com/index.php?topic=562.0
Title: Re: PRECICE 3.0 - Cobalt Chrome - Full Weight Bearing Nail (Crutches) - Delayed
Post by: YourSpaceBoyfriend on November 15, 2016, 11:33:07 PM
nvm
Title: Re: Dr. Paley's New Internal Lengthening Nail..Full Weight Bearing (Almost)
Post by: onemorefoot on November 15, 2016, 11:51:45 PM
Will be Precice 3
or 2.3??? Did Paley figure out the new surgical technique???
Title: Re: Dr. Paley's New Internal Lengthening Nail..Full Weight Bearing (Almost)
Post by: femoral_indecency on November 21, 2016, 02:53:31 AM
This is interesting news. The future is here, folks.
Title: Re: Dr. Paley's New Internal Lengthening Nail..Full Weight Bearing (Almost)
Post by: The Kaiser on November 21, 2016, 10:09:21 AM
I will not be surprise if Paley price it at 100,000$

Anyways, its a big step and hope to see it before i perform the surgery
Title: Re: Dr. Paley's New Internal Lengthening Nail..Full Weight Bearing (Almost)
Post by: EndGame on November 21, 2016, 01:54:58 PM
So I take it that in comparison to the Guichet nail, Precice 2 comes with no clicking pains?

Correct. Internal motor like with current Precise rods, not a painful twist and click like G nail.
Title: Re: Dr. Paley's New Internal Lengthening Nail..Full Weight Bearing (Almost)
Post by: programdude on November 25, 2016, 06:42:28 PM
Price will determine if this is good or bad news(depending if Paley converts exclusively to using it). I found the precice to be a great piece of technology, though seeing as it bent albeit slightly for a few people, more strength would serve it well.
Title: Re: Dr. Paley's New Internal Lengthening Nail..Full Weight Bearing (Almost)
Post by: jbc on November 26, 2016, 11:56:00 PM
I really hoped it would be out by my surgery. Looks like this won't be the case :). I emailed Dr. Paley for additional details and he said he would be the first to get it, as he's the inventor.

Regarding price, I think for people who are committed to doing the surgery with Dr. Paley, this will turn out to be a non-issue, or at worst a mild irritant. I would pay 10K extra to be full weight-bearing, no question - maybe even more. I weigh 160 lbs, so I'm close even with the Precise 2.2.
Title: Re: Dr. Paley's New Internal Lengthening Nail..Full Weight Bearing (Almost)
Post by: EndGame on November 28, 2016, 12:46:49 PM
I really hoped it would be out by my surgery. Looks like this won't be the case :). I emailed Dr. Paley for additional details and he said he would be the first to get it, as he's the inventor.

Regarding price, I think for people who are committed to doing the surgery with Dr. Paley, this will turn out to be a non-issue, or at worst a mild irritant. I would pay 10K extra to be full weight-bearing, no question - maybe even more. I weigh 160 lbs, so I'm close even with the Precise 2.2.

If you can lose 5 lbs of fat, then with the 5-15lbs of muscle loss people experience, you'll be 150 or less probably by week 2-3. I started at 200 and dropped to 190 for example. You'll be safe to stand for 15 second to weigh yourself. They had me standing x-rays at the end. Ask Dr Packer if you want to confirm at your first biweekly checkup but once or twice standing for x-rays when over 150 is fine, but standing 100 times when over and your bend rods. So anyone starting 160 lbs or less the above advice would apply, lose 5 lbs of fat and with the muscle loss you'll get down to 150 or lower, and if new rods cost a lot more they might not be worth the added expense for you. But I agree with jbc, if it's 10k or less extra then go new rods period. After cost of rod removal, home aides, hotel, meds, extra PT sessions, exogen, etc. this all adds up to more like $125k with Paley, plus or minus 10k on how much you use an aide...
Title: Re: Dr. Paley's New Internal Lengthening Nail..Full Weight Bearing (Almost)
Post by: Mdream on December 01, 2016, 02:36:51 AM
Hi have you heard about doing one leg at a time? It takes longer, but you have almost full mobility during the process...
Title: Re: Dr. Paley's New Internal Lengthening Nail..Full Weight Bearing (Almost)
Post by: YourSpaceBoyfriend on December 01, 2016, 07:22:18 PM
With a risk that you can end up with leg discrepancy in a case your second leg bone won't fuse/will have poor growth etc.
Title: Re: Dr. Paley's New Internal Lengthening Nail..Full Weight Bearing (Almost)
Post by: jbc on December 02, 2016, 05:59:33 AM
If you can lose 5 lbs of fat, then with the 5-15lbs of muscle loss people experience, you'll be 150 or less probably by week 2-3. I started at 200 and dropped to 190 for example. You'll be safe to stand for 15 second to weigh yourself. They had me standing x-rays at the end. Ask Dr Packer if you want to confirm at your first biweekly checkup but once or twice standing for x-rays when over 150 is fine, but standing 100 times when over and your bend rods. So anyone starting 160 lbs or less the above advice would apply, lose 5 lbs of fat and with the muscle loss you'll get down to 150 or lower, and if new rods cost a lot more they might not be worth the added expense for you. But I agree with jbc, if it's 10k or less extra then go new rods period. After cost of rod removal, home aides, hotel, meds, extra PT sessions, exogen, etc. this all adds up to more like $125k with Paley, plus or minus 10k on how much you use an aide...

As of today, I'm at 8% bodyfat and 156 lbs. EndGame, you saw me in person, I don't have much more to give :). One of my more acute worries with the surgery is that I'll get to an unhealthy weight. Right now, a lot of it is very useful muscle for the sports I participate in. If I drop 10 lbs, I'd *theoretically* be able to weight-bear on the Precise 2.2, at least partially (of course, I'd follow Dr. Paley and Dr. Packer's instructions to the letter regarding weight bearing).

The more I think about this, the more bummed I am that the new nail is not out. I'm not going to wait, but it would be really nice to have the functional strength of cobalt chromium with the convenience and reliability of the Precise mechanism. This is one of the things that irks me about the FDA - everything takes so long. There are no changes other than the material, and it's already been through trials, why will it be years before it sees the light of manufacture?

(also, I just looked up Exogen, didn't even know it existed. Brilliant!! EndGame, your contributions to this board have been magnificient, even if unintended on your part. I copied the caretaker's name and email address from one of your previous posts. Many thanks!!)
Title: Re: Dr. Paley's New Internal Lengthening Nail..Full Weight Bearing (Almost)
Post by: Stadiometer on January 04, 2017, 08:02:19 PM
As of today, I'm at 8% bodyfat and 156 lbs. If I drop 10 lbs, I'd *theoretically* be able to weight-bear on the Precise 2.2, at least partially (of course, I'd follow Dr. Paley and Dr. Packer's instructions to the letter regarding weight bearing).

The more I think about this, the more bummed I am that the new nail is not out. I'm not going to wait, but it would be really nice to have the functional strength of cobalt chromium with the convenience and reliability of the Precise mechanism.

jbc- I'm confident you already have this information and spoke at length with Dr. Paley, but given your current weight, along with the expected weight loss during lengthening, you should still be able to be fairly mobile with the PRECICE 2.2.

(http://i64.tinypic.com/208k94y.png)

(http://i63.tinypic.com/2j46paf.png)
Title: Re: Dr. Paley's New Internal Lengthening Nail..Full Weight Bearing (Almost)
Post by: jbc on January 05, 2017, 07:31:48 PM
jbc- I'm confident you already have this information and spoke at length with Dr. Paley, but given your current weight, along with the expected weight loss during lengthening, you should still be able to be fairly mobile with the PRECICE 2.2.

Hi Stadiometer,

I really hope that's the case, though the new nail would be a game-changer for me. I contacted Dr. Paley sometime back to ask for details, here is part of his reply regarding the new nail:

"The PT protocols will remain the same. The only difference will be with weight bearing. We will likely allow 100lbs per leg WITH CRUTCHES"

REALLY hoping this is out by the time I have surgery, though not holding my breath :). I will not wait for years though, and will stick to the surgery date and make the Precise 2.2 work under Dr. Paley's protocols.
Title: Re: Dr. Paley's New Internal Lengthening Nail..Full Weight Bearing (Almost)
Post by: The Kaiser on January 07, 2017, 03:01:17 PM
Hi Stadiometer,

I really hope that's the case, though the new nail would be a game-changer for me. I contacted Dr. Paley sometime back to ask for details, here is part of his reply regarding the new nail:

"The PT protocols will remain the same. The only difference will be with weight bearing. We will likely allow 100lbs per leg WITH CRUTCHES"

REALLY hoping this is out by the time I have surgery, though not holding my breath :). I will not wait for years though, and will stick to the surgery date and make the Precise 2.2 work under Dr. Paley's protocols.

weight bearing or not, go to the LL God with an close eyes  ;)