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[endeavor]

Hello everybody. I really appreciate this forum and the open attitudes here, so I was hoping I could have some advice.

This spring or summer, I'd like to lengthen my legs 2-3 cm. There are a number of reasons I don't want additional extension:

1) I enjoy going on long walks and the like. From what I understand, the more you extend, the higher the risk of nerve damage, limited ROM, etc. I'd like to minimize this.
2) My funds are limited.
3) My time is limited (more on this later).
4) I honestly only want 2-3 cm extra. While I don't want as much growth as some other people here, let me assure, I want this just as bad. I have a host of personal reasons for wanting this surgery, and they are VERY strong. I realize that this is painful. I realize that the rehabilitation is nightmarish. I realize that there is a significant risk of complications. I know this, and I am ready to proceed. I have no illusions about the difficulty, but I've dealt with hell before.

As I am trying to organize this logistically, I do have a few questions. I plan on doing a very conventional procedure, single-cut with Ilzarov external fixator. I need something of a timescale for about 2.5 cm of growth. I realize that there are many sample timescales available, but they are all for 5 cm increments or so. I don't think I can simply cut in half--there seems to be too many other variables. I'd like to know if anyone can offer a rough estimate of how long it will take for fixator removal, for walking with crutches, and walking unassisted.

I ask this because I have two time windows, one 2.5 months, the other 3 months. If the surgery cannot be performed in either time window, then I may need to look into postponing.

I know these are general questions and that there is a large range. I would greatly appreciate some general info, however. Thank you in advance.

[Moubgf]

If you are only gonna lengthen 2-3 cm then fk it. Really man? really?

[Medium Drink Of Water]

LON/LATN would be doable in either window for such a small gain, probably with time to spare.  30-45 days of actual turning is all you'll need (accounting for pin bending).  Then 10-14 days of rest after that and you'll be ready to walk.  Your muscles will have so little time to atrophy, and your legs will be so similar to how they were previously, I don't see a long period of recovery for you.  You'll probably be walking unassisted when the 3-month window is over.

I just want to say that I lengthened 7.5cm, and the only real lasting complication I have is knee pain from the IM nail surgery, nothing to do with how much I lengthened.  I could go on a 2-hour walk right now and be fine.

[ChrisIsaak]

Medium Drink of Water,

Thank you for your insight. May I ask how long it took for you to lengthen 7.5 cm, and how long for consolidation? Could you still walk on your external LON fixators while you're lengthening? I am friends with "goodfootballer" from old forum  and used to chat with him over the phone, he lengthened his tibias with Dr. Salameh. He had this cool attitude of "Go all the way you can, man", but I'm afraid when it comes to tibia lengthening since I already have a ballerina foot problem. The only remedy I can think of to that is gastrocnemius-soleus recession (NOT achilles tendon lengthening, aka achillotenotomy, since that's very dangerous and no sane doctor would do it). I'm about to start lengthening my femurs in about 10 days, but I'm also thinking about adding at least 5 cm to my tibias.

[Muse]

Quite a few LL doctors have stated that 5cm would generally be the safe limit.  In my opinion, doing 2-3cm seem too conservative for all the money/time you'll end up spending.   

[Medium Drink Of Water]

Medium Drink of Water,

Thank you for your insight. May I ask how long it took for you to lengthen 7.5 cm, and how long for consolidation? Could you still walk on your external LON fixators while you're lengthening? I am friends with "goodfootballer" from old forum  and used to chat with him over the phone, he lengthened his tibias with Dr. Salameh. He had this cool attitude of "Go all the way you can, man", but I'm afraid when it comes to tibia lengthening since I already have a ballerina foot problem. The only remedy I can think of to that is gastrocnemius-soleus recession (NOT achilles tendon lengthening, aka achillotenotomy, since that's very dangerous and no sane doctor would do it). I'm about to start lengthening my femurs in about 10 days, but I'm also thinking about adding at least 5 cm to my tibias.

I was in Beijing for 5 months, and full consolidation happened sometime between 12 to 15 months after the first surgery.  During the 5 months I could walk and was encouraged to walk.

I can't tell you anything about the achilles tendon/ballerina foot because I barely had any issues there.  I think tibiae were the right choice for me because I was the opposite of you: I had really flexible calves/ankles, but my hamstrings have always been tight.

[endeavor]

LON/LATN would be doable in either window for such a small gain, probably with time to spare.  30-45 days of actual turning is all you'll need (accounting for pin bending).  Then 10-14 days of rest after that and you'll be ready to walk.  Your muscles will have so little time to atrophy, and your legs will be so similar to how they were previously, I don't see a long period of recovery for you.  You'll probably be walking unassisted when the 3-month window is over.

I just want to say that I lengthened 7.5cm, and the only real lasting complication I have is knee pain from the IM nail surgery, nothing to do with how much I lengthened.  I could go on a 2-hour walk right now and be fine.

Thank you for the reply--you seem to be a particularly helpful poster.

My main concern about the LON method (in addition to the higher cost) is having strange pieces of metal remaining in my body long after the surgery. Otherwise, it seems like a far superior option.

My goal with LON would be to operate late March, lengthen through April/early May for total 3 cm. gain, crutches until early June, and mild unassisted walking in mid-June with full recovery by next March or so.

I am not particularly athletic, but I love the outdoors, walking through museums, walking through cities, traveling, etc. I don't want to jeopardize this, but I think that I will be fine with such a minor gain. If 3 cm. is too much, I'll do 2.5. I'm even willing to go down to 2 cm provided I can convince the surgeon, but I would prefer at least 2.5 for all the trouble this is worth.

Thank you to everyone who has responded thus far.

[Medium Drink Of Water]

My goal with LON would be to operate late March, lengthen through April/early May for total 3 cm. gain, crutches until early June, and mild unassisted walking in mid-June with full recovery by next March or so.

That sounds very realistic and possible.

[Sweden]

It's not worth it to permanently hurt your knees for only 2-3cm. You have to be kidding?
Normal shoes bring you higher up than that.

If you are going to do this then at lest do 4-4,5cm. It's also "safe". If you do everything right you can manage it in 3 months too.

Remember, your knees will ache now and the for the rest of your life having an IMnail put in.

[endeavor]

It's not worth it to permanently hurt your knees for only 2-3cm. You have to be kidding?
Normal shoes bring you higher up than that.

If you are going to do this then at lest do 4-4,5cm. It's also "safe". If you do everything right you can manage it in 3 months too.

Remember, your knees will ache now and the for the rest of your life having an IMnail put in.

Thanks for the response. The desire to minimize knee pain is one of the reasons I am opting for 3 cm. of growth. From what I understand, about 73.2% of LON patients experience knee pain. I have no idea whether I'll be in the 26.8% that doesn't, but I know that more limited procedures have a lower risk of complication and lasting side effects, although it seems like there are at least some minor residual effects for everybody. Having said that, I think that my limited lengthening will reduce the probability of knee pain when compared to those undergoing more significant lengthening.

By what mechanism does LON cause knee pain? Is it the IM nail insertion or the rest of the process?

Additionally, I don't think I really need the 4-4.5 cm. I do, however, very much want the 3 cm. Honestly, I would rather be done with the process much earlier so I could work on rehab and prepare to walk at my graduation. If I could be walking unassisted (for short periods) at the 2.5 month mark following 3 cm extension, that'd be great.

By the way, what happens to the screws inside the bone? What about the nail? I don't want these things in my body forever.

[Medium Drink Of Water]

By what mechanism does LON cause knee pain? Is it the IM nail insertion or the rest of the process?

By the way, what happens to the screws inside the bone? What about the nail? I don't want these things in my body forever.

The leading theory on why LON causes knee pain is the nail insertion surgery.  The screws and the nail are removed once your bones have consolidated.

[Muse]

By the way, what happens to the screws inside the bone? What about the nail? I don't want these things in my body forever.

Here's an overview of the various LL techniques

http://www.limblengtheningforum.com/index.php?topic=95.0

[alps]

The leading theory on why LON causes knee pain is the nail insertion surgery. 

So internal methods have the same issue too?
Only externals are safe with regard to knee pain?

[Medium Drink Of Water]

So internal methods have the same issue too?
Only externals are safe with regard to knee pain?

It seems so.  These numbers aren't just from LL patients, they're from anyone who's had an IM nail inserted through the knee for any reason.

[endeavor]

It seems so.  These numbers aren't just from LL patients, they're from anyone who's had an IM nail inserted through the knee for any reason.

After reading Sweden's comments and doing some more research on this, I'm not going to do LON. He's right...messing up my knees for 3 cm. is pretty silly.

If I do external, then I hope I can be functional on crutches within 3 months after lengthening 3 cm. I keep reading wildly divergent things on this; using various persons' estimates, it seems like 3 cm. can have you in the fixators anywhere from 2-6 months

[BilateralDamage]

I think Salameh's external fixator sounds really promising.  I like how it's less noticeable and that you can fit it underneath baggy pants.  A big option for me when I decide on lengthening my tibiae.

External fixators on tibiae are my suggestion for short lengthenings.

[Wannabegiant]

Im in the same boat as the OP and can relate to his goal, i only want about an inch of height increase (4 cms in my case to be exact), as i want to reduce the ammount of time to lengthen, recover, i want to keep my proportions intact, i also want to regain 100% my physical capability. The shorter ammount of time it takes for me to get this done will also make it much easier to keep the surgery a secret from my friends and others. 4 cms would make me about 179 cms tall, thats easily a good enough height for me.

LON/LATN would be doable in either window for such a small gain, probably with time to spare.  30-45 days of actual turning is all you'll need (accounting for pin bending).  Then 10-14 days of rest after that and you'll be ready to walk.  Your muscles will have so little time to atrophy, and your legs will be so similar to how they were previously, I don't see a long period of recovery for you.  You'll probably be walking unassisted when the 3-month window is over.

I just want to say that I lengthened 7.5cm, and the only real lasting complication I have is knee pain from the IM nail surgery, nothing to do with how much I lengthened.  I could go on a 2-hour walk right now and be fine.

^that time to recover sounds incredible, but from my understanding, LON/LATN is much more expensive than externals? and you need another surgery to get out the rod. I intend to do the double incision which will reduce the time i will lengthen by about 40%. so what time to recover would 4 cms of height increase take with externals (ilizarov or monorail), and will the double incision severly increase recovery time so that the lengthening time reduction is canceled out?