Limb Lengthening Forum
Limb Lengthening Surgery => Height & Proportions => Topic started by: LG1816 on June 03, 2023, 12:18:50 PM
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Hi,
I’ve seen a few different ratios for tibia to femur batted around here, but I can’t really find any concrete information on when it is your proportions start to look strange.
I’ll be doing Tibias. Does anyone have any links or formulas that are useful?
Thanks!
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Doing tibia only is kind of stupid in my opinion. Why? Well it heals slower, has a higher complication rate, more likely to have permanant problems with joins / early arthiris, breaking 2 bones instead of 1, and most importantly you can gain much less height safetly (5 cm MAX vs 8 cm MAX). And for the love of god, don't do LON unless you want to the big risk of ostemylisis. Sorry for my gramma right now busy.
https://pubmed.ncbi.nlm.nih.gov/26398436/
https://www.youtube.com/watch?v=SkKr39RU_bo&t=2347s see 11:50 - 14:40
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Overdoing tibias will make you look like a gazelle, overdoing femurs will make you look like a caterpillar.
Limit yourself to a tibia:femur ratio of 1 (you're probably at about 0.8 now). Even that is kind of pushing it but it's still acceptable as long as you wear shorter shirts that don't cover much of your hips/thighs. Looks better than wearing a big baggy shirt that could almost be a dress anyway. ;D
And don't take this paranoid guy too seriously. I did 7.5 cm (for the 1 ratio) on tibias with LON and never even got a superficial pinsite infection. How you take care of yourself makes a big difference; this is not a random gamble.
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most people could handle 7cm in one segment without looking strange, specially in femurs. don't go over that and it will be ok.
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Overdoing tibias will make you look like a gazelle, overdoing femurs will make you look like a caterpillar.
Limit yourself to a tibia:femur ratio of 1 (you're probably at about 0.8 now). Even that is kind of pushing it but it's still acceptable as long as you wear shorter shirts that don't cover much of your hips/thighs. Looks better than wearing a big baggy shirt that could almost be a dress anyway. ;D
And don't take this paranoid guy too seriously. I did 7.5 cm (for the 1 ratio) on tibias with LON and never even got a superficial pinsite infection. How you take care of yourself makes a big difference; this is not a random gamble.
Cheers for the advice! I am indeed 0.8 right now at 5’8.5 evening height. What about sitting height? Is that something to factor into the equation?
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most people could handle 7cm in one segment without looking strange, specially in femurs. don't go over that and it will be ok.
Understood, thanks!
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Doing tibia only is kind of stupid in my opinion. Why? Well it heals slower, has a higher complication rate, more likely to have permanant problems with joins / early arthiris, breaking 2 bones instead of 1, and most importantly you can gain much less height safetly (5 cm MAX vs 8 cm MAX). And for the love of god, don't do LON unless you want to the big risk of ostemylisis. Sorry for my gramma right now busy.
https://pubmed.ncbi.nlm.nih.gov/26398436/
https://www.youtube.com/watch?v=SkKr39RU_bo&t=2347s see 11:50 - 14:40
Thanks for the post, but that paper doesn’t really tell us a lot. What about the ones that show arthritis as a risk for femoral lengthening? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8231406/
I’d be doing pure externals anyway, but Giotikas himself told me that LON was a safe proceedure.
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I’d be doing pure externals anyway, but Giotikas himself told me that LON was a safe proceedure.
A much better choice than LON. It was my first choice but for a couple of reasons beyond my control, that didn't end up happening.
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Overdoing tibias will make you look like a gazelle, overdoing femurs will make you look like a caterpillar.
Limit yourself to a tibia:femur ratio of 1 (you're probably at about 0.8 now). Even that is kind of pushing it but it's still acceptable as long as you wear shorter shirts that don't cover much of your hips/thighs. Looks better than wearing a big baggy shirt that could almost be a dress anyway. ;D
And don't take this paranoid guy too seriously. I did 7.5 cm (for the 1 ratio) on tibias with LON and never even got a superficial pinsite infection. How you take care of yourself makes a big difference; this is not a random gamble.
If someone has perfect ratio of around 0.80-0.82. Wouldnt a femur lengthening of 5 cm ruin it and put it below 0.80? Is it not better to do a tibia lengthening in that case and get a ratio of around 0.90?
Because for me currently I would guess I have around 0.80 ratio (havent done xrays yet) but I do care about the aesthetics aswell and I read that long tibias > long femurs from aesthetic view. What do you think?
I dont wanna end up looking strange
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What about sitting height? Is that something to factor into the equation?
I would only pay attention to sitting height if I were doing more than one LL.
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If someone has perfect ratio of around 0.80-0.82. Wouldnt a femur lengthening of 5 cm ruin it and put it below 0.80? Is it not better to do a tibia lengthening in that case and get a ratio of around 0.90?
Because for me currently I would guess I have around 0.80 ratio (havent done xrays yet) but I do care about the aesthetics aswell and I read that long tibias > long femurs from aesthetic view. What do you think?
I dont wanna end up looking strange
I think that longer tibias in general look better.
I was open to either tibias or femurs before LL, and my doctor examined me and recommended tibias for my body.
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I’d be doing pure externals anyway, but Giotikas himself told me that LON was a safe proceedure.
A much better choice than LON. It was my first choice but for a couple of reasons beyond my control, that didn't end up happening.
Are pure externals still limited to the old Ilizanova devices or are there newer ones in use?
I assume their advantage is that they have a lot of angle control, and can ensure a better fibular growth, along with avoiding internals.
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You can do pure external monorails, and there's a newer successor-in-spirit to the Ilizarov fixator called the Taylor Spatial Frame.
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I think that longer tibias in general look better.
I was open to either tibias or femurs before LL, and my doctor examined me and recommended tibias for my body.
Do some people have the 1:1 ratio naturally? And would the average person notice it if looking at you in your underwear?
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It is a little bit noticeable especially when someone of similar height notices your knees are way higher than theirs.
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During my research I found some studies which recommended that, if you have to choose it would be better to have a low ratio than to high f/t radio because too long tibias will lead to arthritis and other knee problems in a long term.
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It is a little bit noticeable especially when someone of similar height notices your knees are way higher than theirs.
Makes sense. I'm just over 5'8.5 at night, so 6cm would take me to 5'11, but to get to the 1-1 ratio (7.5cm) would take me to a daytime height of the elusive 6'. Do you reckon the trade off of the slightly off 1-1 ratio is worth the 6' height? I would presume not really. I suppose with such a big surgery you're going to want as best a bang for your buck as you can get, but there's a limit I suppose.