I have find a doctor in China using pure external method with traditional frame.
What interests me is the bone cut way. The doctor cut tibia bone twice (upper and lower) and make upper and lower lengthening together, which also make the consolidation quicker.
Does anyone know about the double cut?
I am sorry English is not my first language. Thanks you.
Quote from: raku on November 22, 2018, 04:37:02 PMhttps://pan.baidu.com/s/14sdHLOMftYYzbojBeLKXmg
Yeh I have seen this before in some other surgeon's site. I would advise against it. The Tibia is best done slow and easy. The vascular supply to the tibia is much less than for the femur and the soft tissue is more resistant to stretching. Too risky in my opinion.
Quote from: raku on November 22, 2018, 05:10:09 PMAs it is known to us, pure external is safer than Lon or Latn in tibia.
So do you think if keeping 1.0mm a day lengthening safe? and just let the consolidation period quicker for the gap is smaller both sides?
Thanks
I still think that having two cuts must at least double the risk. Keeping alignment is probably harder too. In any case I would probably do .3mm to .6mm a day max even with a single cut.
Thanks. As for 5-6cm pure external would be wearing 10-12months frame, Do you prefer pure external or Lon/Latn?
Quote from: raku on November 22, 2018, 05:19:33 PMThanks. As for 5-6cm pure external would be wearing 10-12months frame, Do you prefer pure external or Lon/Latn?
I would not do LON/LATN - if you are going to ream your bones and insert a nail then why not just go for a fully internal nail like Precice or Stryde? LON/LATN are legacy technologies in my opinion.
For pure externals I would use a more compact fixator like the SalamehFix - you can wear trousers over them. I met an LLer who completed his Tibias this way and he was able to go to work during lengthening. He had a really good result.
Quote from: raku on November 22, 2018, 04:34:08 PMI have find a doctor in China using pure external method with traditional frame.
What interests me is the bone cut way. The doctor cut tibia bone twice (upper and lower) and make upper and lower lengthening together, which also make the consolidation quicker.
Does anyone know about the double cut?
I am sorry English is not my first language. Thanks you.
Its dual oesteotomy, Pili and Catagni too used to perform. Its faster simce you can go 1.5mm a day, .75mm at each cut. However as others mentioned there is a risk of mal alignment and ATL(stiffness of soft tissues). but of your doctor is confident, and you know how you are lengthening, you should do fine. Good luck 
Quote from: raku on November 22, 2018, 05:19:33 PMThanks. As for 5-6cm pure external would be wearing 10-12months frame, Do you prefer pure external or Lon/Latn?
What about this TSF method people are saykng its 4-5 months frame time ??
Quote from: Kenda on November 22, 2018, 07:13:04 PM
What about this TSF method people are saykng its 4-5 months frame time ??
TSF is just another external fixator - Paley uses it for deformity correction and I believe the Athens Dr uses it for cosmetic LL. It is big and cumbersome but very good for complex bone correction.
The length of time will depend on the lengthening rate and time taken to consolidate. In terms of time with apparatus installed - there is not much difference between internal and external methods. However, external methods present an increased risk of infection and they are more noticeable and inconvenient. Internal nails once lengthening is complete - can be largely forgotten if they are weight bearing until consolidation is complete and the nail is to be removed.
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