I will forward your measurements and comments to the relevant personnel/unit and I will share their explanation here. However, as I said, we do not use the amount of elongation as an "obvious" advertising factor. If I see that your explanations make more sense, not the relevant personnel/unit's, I will not hesitate to make corrections here.
"When evaluating the success of limb lengthening surgery, precise measurements of the gained height increase are important. However, due to various factors, achieving a perfectly consistent measurement across all assessments can be challenging. One of the key factors contributing to this variability is the selection of reference points for measurement.
Reference points serve as the basis for measuring the increase in limb length accurately. These points are used to establish a consistent starting and ending position for each measurement. However, because reference points are often anatomical landmarks, their identification might not always be as straightforward as one would hope. Variability can arise due to individual differences in anatomy, surgeon interpretation, and the effects of the surgical procedure itself. Consequently, a small but consistent discrepancy in reference point placement can lead to minute variations in the recorded height increase after each measurement.
Surgeons and medical professionals often use the standard deviation to assess the precision and reliability of the measurements taken during limb lengthening. A higher standard deviation can be an indicator that the measurements might be influenced by factors such as inconsistent reference point placement or other sources of error. Conversely, a lower standard deviation indicates that the measurements are relatively consistent and reliable, enhancing the confidence in the accuracy of the reported height increase." This is the information given to me by the doctor's assistant. I conveyed as much as I could understand from what she told me.
As much as I understand from what you, and she, said, correcting the image for magnification seems to be one of the possible reasons for deviation too. If I misunderstood, please correct it. If you have suggestions that can reduce the standard deviation in the measurements, be sure that I will transfer them to the relevant personnel/unit with my pleasure.
As I mentioned before, The company's policy is "Less risky less cm is better than more risky more cm." and we are already very modest about lengthening rates:
Optimum rate: 6 cm
If a good preliminary preparation is made / the patient's physiology is suitable / the patient is tenacious in physiotherapy: 7-8 cm.
Therefore, I see no reason to think that there is a tendency to deliberately exaggerate the patient's height gained at the end of the process through measurements. In my opinion, the best way to measure a patient's height gain in the simplest and most concrete way is still a good quality physical height meter/ruler. I recommend that our patients accept the measurement they make with such a height meter/ruler as final.