Hi I did 8 cm on tibias via LATN. The results have been great and there were no long term major complications of note, so inherently I may be biased in support of LATN. But anyway I will give additional pros and cons that most people tend to overlook
Pros of LATN/ Cons of externals
-Risking contractures getting worse: In the frames, the pins and screws attached to your bone limit your muscle movement; this is fact. So lets say you develop contractures with LATN, once your done lengthening, they've inserted the nail and they've removed the frames, your muscles are now free to stretch out and remove the contractures. You could still do this at the end of lengthening with externals but it would be far harder because the frames limit the capacity for your muscles to move and stretch. In the Long term this may not be good as your muscles might be too stiff after frame removal to stretch it effectively
-Less time in isolation: Tough choice: do you want to be seen publicly in the frames or be isolated away from the eyes of people you know, either by staying alone or being in a foreign country? Either way LATN will significantly decrease the amount of 'downtime' you have to spend. Do consider the prolong mental health effects of being away/ isolated from your friends and family in the name of secrecy
-Daily routine: Depending on your doctor, he will either allow you to bathe normally daily but also do daily pin site care or not allow you to wet your legs and allow less frequent pinsite care. Either way, do account for the fact you have to spend upwards of 1 year going through this time consuming routine, whereas with LATN you'd probably have to only do this as long as you have the exfix
- Better bone healing: Dont take my word for it. You should read the study by Dr Rozbruch comparing LATN to externals only. The bone healing index is better in LATN than externals only
(about 2 times faster). This would lower the risk for refractires, especially considering you can keep the nails in you as long as needed.
Cons of LATN/ pros of external
-Cost: the nails and extra surgery will cost more. In my case, if I chose externals only the cost totally would have been halved. Even now I need to consider how much the nail removal cost will be in the future
- Knee pain: this is a well known risk but do consider this; even for non-LL cases like distal tibial fractures and leg deformity correction, using an intramedullary nail has become standard practice in orthopaedics. So this should be a minor risk in the hands of an experienced surgeon and hence preventable if you go to a reputable doctor and not some quack
-Scars: More scars in LATN. Not much of a problem if you're hairy
-Loss of height during nailing surgery: Yes this is true. When I developed contractures during lengthening, my surgeon warned me that the tight muscles could pull my bones together as they remove the fixators and insert the nail, causing a loss of height lengthened. Thankfully in my case it did not happen: I lengthened 8 cm and had 8 cm at the end of lengthening confirmed by X-Rays. But still, do consider the possibility of this
My view is that LATN is better. I can't imagine the mental toll in being stuck in frames for so long, a year or more, alone and isolated from the ones that I know. I'd very much prefer to recover faster and return back to normal life in less than 6 months which is possible with LATN.
Author
Topic: LATN or Externals only? (Read 2868 times)