Most of the recent posts nowadays focus on internal limb lengthening techniques, but I’m curious about the relative risk of severe complications between fully external methods and newer approaches.
Setting aside the well-documented infection risks and avoiding a detailed comparison of the pros and cons of each lengthening method so as not to digress, my interest lies in the following:
Fat embolism: I would assume the risk is minimal. To my understanding, fat embolism risk arises from bone reaming, moving fat droplets into the bloodstream, a process not involved in externals.
Pulmonary embolism: I’m uncertain about the causes and the extent to which medication can reduce risks. Would most risks occur post-operatively rather than during surgery?
I recall reading that tibial lengthening poses lower risks than femoral naturally, regardless of internal or external methods, due to less risk of dangerous clot migration to vital organs. Does the risk vary with external frames alone?
Non-Union: My main concern with limb lengthening is non-union, which is known to have slightly higher risks with tibial procedures. Despite knowing the risk factors like smoking and lengthening pace from past discussions, what are the chances of non-union if these factors do not apply?
It seems that individuals who develop non-union may have pre-existing bone conditions, facing similar issues if they were to break a bone naturally. There are alarming stories of potential amputation/permanent disability, but in worst-case scenarios with external frames, couldn’t the frame be reversed to realign the bones?
Thank you!
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