Limb Lengthening Forum

Limb Lengthening Surgery => Limb Lengthening Discussions => Topic started by: Notepadman on December 21, 2019, 11:49:38 PM

Title: Whats the problem with externals on femurs
Post by: Notepadman on December 21, 2019, 11:49:38 PM
Some people on this forum say it like it is universall fact that external femur is really bad and everyone should know this

okay i buy it

but how come some credible doctors offers this procedure then ?? i dont get it is it bad or not
Title: Re: Whats the problem with externals on femurs
Post by: Montreal172 on December 22, 2019, 12:17:19 AM
money
Title: Re: Whats the problem with externals on femurs
Post by: Notepadman on December 23, 2019, 04:17:18 PM
money

okay but what is bad about it
Title: Re: Whats the problem with externals on femurs
Post by: California2 on December 23, 2019, 04:40:46 PM
Your question is very broad--if you asked a more narrow and pointed question; then, you might get a more helpful response.

External femur lengthening is a safe and viable option for many people.  The problem with the technique is that it is very challenging to lengthen both femurs at the same time.  Some on this forum (i.e., "Pope") successfully managed the procedure.

Bilateral external femurs are challenging because you are essentially bed-ridden throughout the procedure.  Why are you bed-ridden?  Because the frames around your thighs prevent you from using a wheelchair.  You cannot really scoot forward in a wheelchair to get your backside on the seat and still use the wheelchair.

As a result, most folks who do external bilateral femurs stay in a hospital throughout the procedure.

Otherwise, you can do one leg at a time.  I am not fond of cross-lengthening or doing one leg at a time because you can never be certain that both legs will cooperate so that you get equal length.  In contrast, when you are doing both legs at the same time, if one leg has a problem, you can stop lengthening the other leg until the problem is resolved.

Merry Christmas!
Title: Re: Whats the problem with externals on femurs
Post by: InFullStryde on December 23, 2019, 06:07:31 PM
With bilateral femurs; rehab is very difficult. Any case studies on this?
Title: Re: Whats the problem with externals on femurs
Post by: KiloKAHN on December 23, 2019, 06:09:26 PM
From Dr Parihar's Q & A:

In the case of femoral lengthening, a longer lengthening may be possible, because it's surrounded by muscle (unlike the tibia where there are less muscles and more tendons - comparatively speaking). Having said that, external lengthening on the femur tends to cause more problems with muscle scarring and consequent stiffness, compared to the tibia, precisely because the femur is surrounded by muscle. So what one gains in length, one may lose in terms of function. This is the primary reason why most surgeons would not do external femoral lengthening for CLL.

http://www.limblengtheningforum.com/index.php?topic=2783.msg43784#msg43784
Title: Re: Whats the problem with externals on femurs
Post by: California2 on December 23, 2019, 07:52:01 PM
I tend to respectfully disagree with Parihar's conclusion -- many competent LL surgeons do external lengthening of femurs.  Also, to suggest that external procedures cause more scarring that somehow impair the result is just not a supportable opinion.

External procedures certainly create more scars on the outside; however, these scars fade over time.

External also causes pins or wires to be inserted through muscle; however, the intrusions are very small.  To opine that these intrusions create scars that impair function seems irresponsible.  I know of no reliable study that concludes external pins or wires causes scarring or stiffness that impairs function.
Title: Re: Whats the problem with externals on femurs
Post by: Medium Drink Of Water on December 23, 2019, 08:24:56 PM
When I was in Beijing, almost everyone did external tibias except for the one external femur patient.  He was bedridden in the hospital the whole time, even needing help to use the toilet.  He used the word "agony" to describe how he felt constantly.

In Serbia, I had met a patient who was physically and mentally stronger who did femurs with Dr. Mitkovic.  He'd just completed external tibias and had left those devices on for the bones to consolidate while he did femurs.  He rented an apartment in Serbia and got through it on his own with limited help, but life was a painful struggle, much worse than when he'd done tibias, and he wished that he'd done internal femurs.

That's 2 of 2 patients I've met in person who did it and don't recommend it to others.
Title: Re: Whats the problem with externals on femurs
Post by: California2 on December 23, 2019, 09:45:22 PM
To be clear, I am not recommending bilateral external femurs--only commenting that the procedure can be done, is successfully done by competent top-shelf surgeons, and has been done by folks on this list.

I personally think that bilateral external femurs would be a very hard choice.

Title: Re: Whats the problem with externals on femurs
Post by: Notepadman on December 26, 2019, 11:12:38 PM
Your question is very broad--if you asked a more narrow and pointed question; then, you might get a more helpful response.

External femur lengthening is a safe and viable option for many people.  The problem with the technique is that it is very challenging to lengthen both femurs at the same time.  Some on this forum (i.e., "Pope") successfully managed the procedure.

Bilateral external femurs are challenging because you are essentially bed-ridden throughout the procedure.  Why are you bed-ridden?  Because the frames around your thighs prevent you from using a wheelchair.  You cannot really scoot forward in a wheelchair to get your backside on the seat and still use the wheelchair.

As a result, most folks who do external bilateral femurs stay in a hospital throughout the procedure.

Otherwise, you can do one leg at a time.  I am not fond of cross-lengthening or doing one leg at a time because you can never be certain that both legs will cooperate so that you get equal length.  In contrast, when you are doing both legs at the same time, if one leg has a problem, you can stop lengthening the other leg until the problem is resolved.

Merry Christmas!

All right thanks. maybe bilateral tibia with externals and then internals for femur could work.. Hm... Does anyone know if kulesh and solomin do internals?? i read before on this forum that it was not allowed in russia yet