Here are the responses from Dr Alex Monegal of Clinica Diagonal based in Barcelona, Spain.
Note: please refer to our disclaimer about The Doctors Directory http://www.limblengtheningforum.com/index.php?topic=55.0
Method of Surgery
Presentation Fitbone:
http://www.mediafire.com/view/he6f42q1r3fqfa9/Presentaci%C3%B3n_Fitbone.pdf
" I recommend to use intramedullar devices. I use Fitbone since 2009. We can lengthen up to 8cm in fémur and 6 in tibia. It depends on your current height and the tibio-femoral proportion What i might advice you to lengthen. Other options are external fixators but i do not use It for Cosmetic, just for trauma.
My advice is to do one limb and then the other. Walking on crutches is straight away after surgery (15-20k of bearing). Lengthening time for 6cm is approximately 3 months and 6 to 8 weeks after you must be fully weight bearing. I recommend to perform second limb when the first one is fully recovered.
It is very important to achieve proportion. It is obviously more expensive to do all 4 bones but result is better in terms of Cosmetic.
I am using the most recent version of the Fitbone technologies as I am official Fitbone user here in Spain. So I use the Fitbone 4. They are currently working on a new version but won't be released until 2017-2018.
My advice is to start with one leg doing 1 or 2 segments (femur and tibia), and then proceed with the other one.
Reasons for performing a Two stage lengthening are extremely important.
First of all the risk of fat embolism syndrome increases. I do bilateral in dwarfism on a regular basis. Problem is that post operative management is far away much worst. If for instance we do perform both tibias at the same time patient must remain on a wheelchair with both limbo extended as you might have seen in the presentation I sent you. On the other hand if we do a Two stage lengthening you will be Able to walk with crutches loading 18-20kg on the operated limb.
Second limb will be performed 6 to 8 weeks first limb is completed depending on how the first limb recovers and how fast you create new bone.
Wanna do a 1 stage procedure? We can discuss It but My advice remains the same. I would do 2 stage. "
Pricing
"The plan for Cosmetic is to perform first one leg and then the other one.
There are 2 options for treatment. To lengthen 1 segment or 2 segments on each limb.
Total cost for bilateral 1 segment lengthening is 2 x 17900€ (Euros) = 35800€
Total cost for bilateral 2 segment lengthening is 2 x 30600€ (Euros) = 61200€
Budget will include
- Hospital stay Includes 4 nights
- Operating Room
- Scrub nurse
- Anesthesist
- Assistants
- Surgeon Including 2 Surgeons
- Implants
After procedure is completed implants must be removed. Implants need to be removed 2 years after finishing lengthening. I will not charge you for removal of implants. You will have to Pay only for hospital expenses which might be 1500-2000€. "
Doctor's Background
" All doctors allowed to use Fitbone are trained by the company and It takes more than 2 year to be approved by the company. So all surgeons are limb lengthening specialists and we do meet on a regular basis at Fitbone users meeting.
My training in lengthening has been beside the most experienced doctor in bone distraction Ignacio Ginebreda and José María Vilarrubias. I spent 9 years with them. I have Also been trained in Germany with Reiner Baumgart and i go to operate with Him on a regular basis since 2009. I have been working at University Hospitals coventry Warwickshire for 18 months performing complex limb reconstruction. I have Also been in Baltimore USA last summer with Dr Standard and Herzemberg where they introduced me to Precice technique
We always use the latest version of Fitbone implants as the company brings the latest version to us. There are few Fitbone users worlwide and we are selected surgeons trainned by them for such procedure.
You will see patients sitting on a wheelchair as they did both femur/tibia at the same time. This is very dangerous. So my advice is to do first one limb and then the other one.
Number of Lengthenings well beyond 500 segments. Using Fitbone technique more than 50 in the last 5 years. Sorry I can't say an exact number."
Contact Info:
Dr Alejandro Monegal Avila
Clinica Diagonal
Email : [email protected], [email protected]
Website: http://www.clinicadiagonal.com/en/trauma-and-orthopaedic-surgery
Tel: 902 88 33 55 / 932 05 32 13
Address: C/ Sant Mateu, 24-26 08950 Esplugues de Llobregat, Barcelona Spain
Dr Alex Monegal (Barcelona, Spain) Clinica Diagonal
Im also quite confused about the pricing, mainly the wording of it. Could you please clarify?
Is segment 1 the tibia or femur? Or doesnt it matter?
Also regarding the hospital stay that is included in the packaged price, how many days in the hospital is it for? The whole distraction phase or 4-5 days and then leave?
A segment refers to either the tibiae or the femurs.
Quote from: KirP1 on July 03, 2014, 01:06:22 AMHello. Im from spain. The price for lengthening both tibias is 35.800 euros? And tibias and femurs 61.200?
Quote from: ShortyMcShort on July 03, 2014, 04:30:18 PMIm also quite confused about the pricing, mainly the wording of it. Could you please clarify?
Is segment 1 the tibia or femur? Or doesnt it matter? Also regarding the hospital stay that is included in the packaged price, how many days in the hospital is it for? The whole distraction phase or 4-5 days and then leave?
I've updated the pricing information and also the presentation fitbone file of Dr Alex Monegal (mainly written in Spanish with some English text). Hope this helps.
Living in Spain sounds very appealing. Perhaps they'd offer Precice soon as well.
So if someone wanted to do both the tibias and femurs, this doctor would do it on one leg first then the other once the first one has consolidated? Or did I misread that? He prefers to do a 2 stage over a one stage operation?
How does one combat the height difference between the two legs while lengthening? Say one leg is 10-12 cms more than the other. Wonder how long that would take to finish.
61200€ for all 4 segments sounds very appealing
From what I've seen in the presentation, it seems like this doctor inserts the Fitbone nails into the femur canal through the knee, and also breaks the femur quite close to the knee.
Knowing what we know from patients that have had nails inserted like this into their tibias and their high rate of permanent knee pain problems, this is a big no no.
I wonder if he'd insert the nails through the side of the hip, like other doctors do, if we asked him.
Hello all.
I am Dr Monegal And i have been working with Dr Ginebreda for 9 years. I have been the guy in Charge of Fitbone project in Dexeus And I changed clinic a few months ago. Dr Ginebreda continues performing cases but he is not very keen to perform cosmetic. If you want to contact him you will fins his contact details at www.fitbone.com
About pricing, in the new clinica it is 5000 to 6000€ cheaper per segment. And when I say segment I am refering to bone (fémur or tibia)
About the discussion of performing a 1 or a 2 stage lengthenning i must say I have done both. Life quality And recovery is much better with a 2 stage. Apart from that, from a Medical Point of view it is much safer. We presented some cosmetic cases performed in 1 stage at Last years Fitbone users meeting in Aalborg (denmark) And all Fitbone users found them extremely risky.
It is true we create a temporary limb lenght discrepancy which can be compensated othopedically. But believe me it is much better to deal with this rather than with fat embolism syndrome.
My best regards for all
Hi,
What is the total price here? fitbone is expensive, right? I could not find the price on that website.
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