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Author Topic: What's the maximum safe lengthening for tibias? Is 6-7cm good?  (Read 5376 times)

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Too little lengthening and all the struggle might not worth it.

I'm 167cm so I want to be get as close to 5'9" as possible with only one segment.
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paco1

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Re: What's the maximum safe lengthening for tibias? Is 6-7cm good?
« Reply #1 on: April 27, 2018, 11:50:07 AM »

5 cm . You forgot 6 cm
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Re: What's the maximum safe lengthening for tibias? Is 6-7cm good?
« Reply #2 on: April 27, 2018, 12:48:20 PM »

5 cm . You forgot 6 cm

Really? From what I read 6cm or even 7cm is still safe.
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Life

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Re: What's the maximum safe lengthening for tibias? Is 6-7cm good?
« Reply #3 on: April 27, 2018, 01:50:49 PM »

I think you should forget what you read in this forum of deluded people who want to lengthen 20 cm and listen to real patients like Paco1 who did tibiae. He's right.
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myloginacct

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Re: What's the maximum safe lengthening for tibias? Is 6-7cm good?
« Reply #4 on: April 27, 2018, 02:00:54 PM »

Technically, you want to measure your tibias and lengthen under 20% of their length. Under 15% to be extra "safe" (remember we are talking about CLL).

5cm is just a safer number for most people, so it is often quoted. But 5cm in a dwarf and a 180cm man are two different beasts.

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The complications during lengthening are more frequent as the tibia is increased by more than 20% of its initial size. In our series, all patients had lengthening of more than 15% of their tibia, which explains the highest number of category II patients (almost 50% of the total series). Therefore, in our opinion, during lengthening of the tibia with the Ilizarov device, approximately one in two patients requires a secondary surgical procedure not planned in the initial lengthening programme.

One of the most common complications of tibial lengthening with an Ilizarov device is the decreased range of motion in the Achilles’ tendon. Even though we performed one Achilles’ lengthening in our series, we believe that physiotherapy focused on the stiffness seems more appropriate than surgery, which can weaken the Achilles’ tendon.

Abstract:

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The Ilizarov technique has been used to treat severe limb length discrepancy and short stature. However, complications of this treatment are frequent. Between 1984 and 2001, 57 patients (94 tibias) had an Ilizarov procedure for limb lengthening. Twenty patients had limb discrepancy and 37 had short stature. Their mean age was 20.2 years (range 15–34). The average limb lengthening was 8.37 cm (range 3.2–14.7), which was equivalent to 26% (range 9.2–60%) average tibial lengthening. A total of 90 complications were observed. Thirty-three unplanned procedures were required during the lengthening programme. Two patients stopped the lengthening programme. There was no difference in the complications in leg lengthening using Ilizarov technique between the group of patients with leg length discrepancy and the group with short stature. A good knowledge of the Ilizarov technique is necessary to perform a lengthening programme with a low rate of complications.

Bear in the mind the change of your tibial:femoral ratio will likely increase your chance of osteoarthritis too.
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..

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Re: What's the maximum safe lengthening for tibias? Is 6-7cm good?
« Reply #5 on: April 27, 2018, 02:12:05 PM »

I think you should forget what you read in this forum of deluded people who want to lengthen 20 cm and listen to real patients like Paco1 who did tibiae. He's right.

Oh no, 20cm never crossed my mind. But it'd be great if I could reach closer to 5'9" which means I need about 3".

Technically, you want to measure your tibias and lengthen under 20% of their length. Under 15% to be extra "safe" (remember we are talking about CLL).

5cm is just a safer number for most people, so it is often quoted. But 5cm in a dwarf and a 180cm man are two different beasts.

Abstract:

Great. Does it start from the knee when measuring tibia?

If I'm 167cm with normal proportions, is it likely that 5cm is under 15% of my tibias?

If it's too little, all the troubles aren't worth the height...

EDIT: Just now measured my tibia is around 32cm (if done more or less right). Which means 15% is 4.8cm while 20% is 6.4cm. So 6cm might be fine afterall. But I need to know if I measured it correctly.
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myloginacct

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Re: What's the maximum safe lengthening for tibias? Is 6-7cm good?
« Reply #6 on: May 02, 2018, 12:47:42 PM »

Oh no, 20cm never crossed my mind. But it'd be great if I could reach closer to 5'9" which means I need about 3".

Great. Does it start from the knee when measuring tibia?

If I'm 167cm with normal proportions, is it likely that 5cm is under 15% of my tibias?

If it's too little, all the troubles aren't worth the height...

EDIT: Just now measured my tibia is around 32cm (if done more or less right). Which means 15% is 4.8cm while 20% is 6.4cm. So 6cm might be fine afterall. But I need to know if I measured it correctly.

You want to go to an orthopedist or orthopedic surgeon and tell her/him you want to take x-rays to have your leg bones measured, as far as I'm aware. I wouldn't know how it works from there, as I'm yet to do it myself.
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Knik

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Re: What's the maximum safe lengthening for tibias? Is 6-7cm good?
« Reply #7 on: May 02, 2018, 02:00:10 PM »

3 cm at best, anything above 3 cm is no way
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ramaka

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Re: What's the maximum safe lengthening for tibias? Is 6-7cm good?
« Reply #8 on: May 02, 2018, 03:00:26 PM »

Let’s be totally honest no amount of lengthening is ever safe it’s just certain doctors have different opinions of what is safe for example paley who is probably the best option if you want the safest option and he says that 8 cm tibia and 6 cm femurs might have the two confused but these are his requirements if you want to stick to safety personally if I were you I’d do the two segments 5 cm + 5 cm tibia and femurs would bring you to close to 5’10 plus I’d be safer
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..

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Re: What's the maximum safe lengthening for tibias? Is 6-7cm good?
« Reply #9 on: May 02, 2018, 04:15:23 PM »

Let’s be totally honest no amount of lengthening is ever safe it’s just certain doctors have different opinions of what is safe for example paley who is probably the best option if you want the safest option and he says that 8 cm tibia and 6 cm femurs might have the two confused but these are his requirements if you want to stick to safety personally if I were you I’d do the two segments 5 cm + 5 cm tibia and femurs would bring you to close to 5’10 plus I’d be safer

But 2x surgery means that it's twice as dangerous and the athletic mobility would be twice more fked up?

I mean I assume doing only 1 segment of 5cm is safer than doing 2 segments of 5cm each? First surgery, you come out in one piece, the second you might not. lol
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Body Builder

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Re: What's the maximum safe lengthening for tibias? Is 6-7cm good?
« Reply #10 on: May 02, 2018, 04:21:00 PM »

3 cm at best, anything above 3 cm is no way
BS from people that never did LL and have almost no idea how it is.

Personally, till almost 6cm my rom was almost normal. After that and to avoid premature consolidation (which was very possible at my case) I lengthened almost 0.8-1mm everyday up to 7.5 cm and that lead to severe equinus.

I believe that if I lengthened slowly (at 0.5mm max per day) maybe I could reach almost 7cm without major problems.
But thats me.
Someone else could face major equinus after 5-5.5 cm. But all these bs about 3cm and breaking your legs for so minimum lengths is only a joke.
I can guarantee that at least 90% of patients could lengthen 5cm on tibias without major problems and more than 50-60% can reach 6cm without problems too.
I don't advice anyone to go further than that as 1-1.5cm more does not worth the possible complications but doing less than 5cm does not worth doing LL at all.

Only a moron could break his legs for 3cm.

That said, I hope you didnt say that ironically because then I apologize for my aggressive tone, but if you really believe that anything more than 3cm could cause problems then you are a complete idiot.
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myloginacct

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Re: What's the maximum safe lengthening for tibias? Is 6-7cm good?
« Reply #11 on: May 02, 2018, 04:38:30 PM »

Let’s be totally honest no amount of lengthening is ever safe it’s just certain doctors have different opinions of what is safe for example paley who is probably the best option if you want the safest option and he says that 8 cm tibia and 6 cm femurs might have the two confused but these are his requirements if you want to stick to safety personally if I were you I’d do the two segments 5 cm + 5 cm tibia and femurs would bring you to close to 5’10 plus I’d be safer

Everything is relative if you want to go down that route. No surgery is 100% safe.

But doing limb shortening to correct a few millimeters leg discrepancy, and in children? That's as safe as anything involving external fixators can get, as far as I have read. Obligatory disclaimer: I'm not a doctor.

However, I agree with your mentality. It's much better to be cautious with CLL.

Quote
for example paley who is probably the best option if you want the safest option and he says that 8 cm tibia and 6 cm femurs might have the two confused but these are his requirements

Lengthening the tibias more than the femurs is almost never going to be the optimal option with anything regarding LL. It's essentially never.
« Last Edit: May 02, 2018, 05:42:07 PM by myloginacct »
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Johnson1111

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Re: What's the maximum safe lengthening for tibias? Is 6-7cm good?
« Reply #12 on: May 02, 2018, 04:39:24 PM »

Is it basically the taller you start the more lengthening you can generally do with less problems?
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myloginacct

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Re: What's the maximum safe lengthening for tibias? Is 6-7cm good?
« Reply #13 on: May 02, 2018, 05:07:42 PM »

Is it basically the taller you start the more lengthening you can generally do with less problems?

Initial bone length. That's what papers seem to suggest (again, I'm no doctor).

Some people have most of their height from their torso, and others from their legs.

People with longer leg bones do relatively smaller increases of their initial bone length, percentage-wise, for the same hard number as someone with a shorter bone.

To quote Bruce:

Quote
Just now measured my tibia is around 32cm (if done more or less right). Which means 15% is 4.8cm

Someone with 37cm long tibias could lengthen his tibias 5.5cms and that'd be relatively the same as Bruce's 4.8cm - a 15% increase of the initial bone length.

A 4.8cm increase in 37cm tibias would be a 13% increase of their initial bone length.

But the only real way to accurately measure your bone length is with x-rays. Bruce's number is probably wrong, and I just used it as an example.

And remember the lengthened amount is just one of the variables for risk in CLL. A number of other, different things could go wrong under the hands of the wrong surgeon or sheer bad luck.
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Android

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Re: What's the maximum safe lengthening for tibias? Is 6-7cm good?
« Reply #14 on: May 02, 2018, 05:51:08 PM »

I hope you didnt say that ironically because then I apologize for my aggressive tone, but if you really believe that anything more than 3cm could cause problems then you are a complete idiot.

Pretty sure Knik was trolling. About half of his posts are sarcastic, facetiousness is hard to detect online. That's why we have handy "/s" to denote sarcasm, but it's unreasonable to expect everyone to use it (especially since they want you to react to it).

That aside, I agree with you that 3 cm is not worth the suffering, unless there are existing problems (varus, valgus, discrepancy, etc.). If correcting leg shape is the main goal, which is the case for many female CLL patients, a little height boost is a bonus.
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5'4" and 1/4" (163.2 cm) | United States | early 30s | Cross-lengthening with Dr. Solomin & Dr. Kulesh

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Re: What's the maximum safe lengthening for tibias? Is 6-7cm good?
« Reply #15 on: May 02, 2018, 07:16:10 PM »

I will say 5 cm is 100% safe (with a good doctor), 6 to7 cm -  a bit risky, above 7 - high risk, above 8 - asking for trouble
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myloginacct

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Re: What's the maximum safe lengthening for tibias? Is 6-7cm good?
« Reply #16 on: May 02, 2018, 07:23:29 PM »

I will say 5 cm is 100% safe (with a good doctor), 6 to7 cm -  a bit risky, above 7 - high risk, above 8 - asking for trouble

Outdated, but I feel I need to relink this.
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Hamiltonzac

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Re: What's the maximum safe lengthening for tibias? Is 6-7cm good?
« Reply #17 on: May 04, 2018, 02:52:30 AM »

I think in general if you want a significant lengthening(9+cm) you should split that into both tibia and femur. 5cm for tibia and mabey another 5-7cm on the femurs, which is all within a safe range. If you don't have the time nor money for both than just do 5cm in your tibia or mabey even 6. Only an idiot would do 3cm. It would not only be a complete waste of money but I can imagine the struggle LLers go through with this surgery so it's no easy task, not worth it for 3cm.
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..

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Re: What's the maximum safe lengthening for tibias? Is 6-7cm good?
« Reply #18 on: May 04, 2018, 08:03:23 AM »

I think in general if you want a significant lengthening(9+cm) you should split that into both tibia and femur. 5cm for tibia and mabey another 5-7cm on the femurs, which is all within a safe range. If you don't have the time nor money for both than just do 5cm in your tibia or mabey even 6. Only an idiot would do 3cm. It would not only be a complete waste of money but I can imagine the struggle LLers go through with this surgery so it's no easy task, not worth it for 3cm.

You think tibia is safer than femur?
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myloginacct

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Re: What's the maximum safe lengthening for tibias? Is 6-7cm good?
« Reply #19 on: May 04, 2018, 09:14:18 AM »

I think in general if you want a significant lengthening(9+cm) you should split that into both tibia and femur. 5cm for tibia and mabey another 5-7cm on the femurs, which is all within a safe range. If you don't have the time nor money for both than just do 5cm in your tibia or mabey even 6. Only an idiot would do 3cm. It would not only be a complete waste of money but I can imagine the struggle LLers go through with this surgery so it's no easy task, not worth it for 3cm.

It's good to have case studies of both people who lengthened too much and too little in scientific literature.

The long-term side effects of CLL in adults are still not well reported. You're not just stretching the soft tissues, even the blood vessels get stretched.
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Re: What's the maximum safe lengthening for tibias? Is 6-7cm good?
« Reply #20 on: May 04, 2018, 09:22:35 AM »

It's good to have case studies of both people who lengthened too much and too little in scientific literature.

The long-term side effects of CLL in adults are still not well reported. You're not just stretching the soft tissues, even the blood vessels get stretched.

  man, that sounds scary.
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myloginacct

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Re: What's the maximum safe lengthening for tibias? Is 6-7cm good?
« Reply #21 on: May 04, 2018, 09:33:44 AM »

  man, that sounds scary.

Pretty sure you've already seen the worst in CLL, but there's also anecdotal evidence of people being fine many years later.

http://www.limblengtheningforum.com/index.php?topic=2046.0
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Hamiltonzac

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Re: What's the maximum safe lengthening for tibias? Is 6-7cm good?
« Reply #22 on: May 04, 2018, 01:43:44 PM »

In my opinion if LL was dangerous to the extent where you would say, lose the ability to walk, then they would not even be allowing this procedure to happen, especially in the states. From what I have heard from others on this forum they say that femurs are safer, don't know for sure. Your stretched muacles and blood vessels, ect your body can get used to as long as you don't do too much in one segment but the only worry I have is Early arthiritis. It would be good if we had more people updating us on years later recovery.
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myloginacct

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Re: What's the maximum safe lengthening for tibias? Is 6-7cm good?
« Reply #23 on: May 04, 2018, 02:29:39 PM »

In my opinion if LL was dangerous to the extent where you would say, lose the ability to walk, then they would not even be allowing this procedure to happen, especially in the states. From what I have heard from others on this forum they say that femurs are safer, don't know for sure. Your stretched muacles and blood vessels, ect your body can get used to as long as you don't do too much in one segment but the only worry I have is Early arthiritis. It would be good if we had more people updating us on years later recovery.

Third time I'm linking it in this thread I think, but the way to prevent osteoarthritis is to keep a good tibial:femoral ratio.

https://www.ncbi.nlm.nih.gov/pubmed/26398436

This, however, only really applies to people who are going to do both segments or cross lateral. The people doing tibias will just have to be conservative or deal with it.
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myloginacct

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Re: What's the maximum safe lengthening for tibias? Is 6-7cm good?
« Reply #24 on: May 04, 2018, 03:17:12 PM »

In my opinion if LL was dangerous to the extent where you would say, lose the ability to walk, then they would not even be allowing this procedure to happen, especially in the states. From what I have heard from others on this forum they say that femurs are safer, don't know for sure. Your stretched muacles and blood vessels, ect your body can get used to as long as you don't do too much in one segment but the only worry I have is Early arthiritis. It would be good if we had more people updating us on years later recovery.

Well, the crap doctors got it banned in China.

And regarding the West, well...

https://en.wikipedia.org/wiki/Lobotomy


If external fixators weren't so important in treatment limb deformities in children, doing corrections, limb reconstructions, etc, there could have been a push to get cosmetic LL banned. It might still get banned (more likely scenario: just regulated) in the future, as CLL "industry" starts to bloom, and if scientific papers find a causal link between the procedure and much increased risks of mortality --- specially if new, safer methods of height increase have already become available at the time.
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Hamiltonzac

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Re: What's the maximum safe lengthening for tibias? Is 6-7cm good?
« Reply #25 on: May 12, 2018, 05:17:44 AM »

I think in general if something becomes so vastly popular then no doctor would agree to get it banned as they also profit from it(that is if they have evidence that it is safe). I recall this article of a person changing their eye colour via lens insert by surgery, dangerous so to speak and not fda approved material used, ect. Of course it's banned in the States. My point is, that eye surgery is Not illegal in the U.S if its for patients who NEED it because of, say an injury. If they wanted to they could make it illegal, if they had a good enough reason(CLL). The doctors wouldnt exactly be out of business either, I would assume 70% or more of they're patients are there for non cosmetic reasons.
But I get what your saying. Now I'm sure there are hundreds who are living just fine after this surgery, if they had major problems its only fair to assume that they would speak up or warn others. It's 2018 after all, people would warn others, well, I know I would.
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myloginacct

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Re: What's the maximum safe lengthening for tibias? Is 6-7cm good?
« Reply #26 on: May 12, 2018, 03:50:27 PM »

Cropped a pic posted around these parts for ease of use later:



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