Dr Franz Birkholtz - CLL in Stellenbosch, South Africa

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Posted on Jun 18, 2026, 8:37 pm

Good to see your return, Dr Birkholtz. Glad you're well.

For those that weren't here a few years back, one of our former mods named TRS had internal femur lengthening with Dr Birkholtz and reported a good result.

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Franz

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Posted on Jun 18, 2026, 8:37 pm

Dear Patient,

In light of the fact that responsible, cost effective and ethical limb lengthening in the world is getting rarer, I have reconsidered my stance on CLL.

I offer CLL in highly selective cases for either femoral, tibial or both. My technique of choice for CLL is internal lengthening nails. We have access to both the Precice and Fitbone products.

These services are provided in Stellenbosch, South Africa at the Mediclinic Winelands Orthopaedic Hospital. We are part of the Institute of Orthopaedics and Rheumatology, a Specialist Institute based at the Hospital. There is a great rehabilitation facility available and the expectation is that the patient will have the benefit of my multi-disciplinary team during their stay.

Stellenbosch is a University town in the Western Cape Province of South Africa - a really beautiful and safe place.

Contact details:
www.birkholtz.health
[email protected]

I will monitor the thread and answer reasonable questions, but will limit my time on the forum.

Best,

Franz Birkholtz
Orthopaedic Limb Lengthening and Reconstruction Surgeon

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Posted on Jun 18, 2026, 8:37 pm

你是缺钱了吧...不过你技术应该会不错

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Franz

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Posted on Jun 18, 2026, 8:37 pm

Hehe

I am so glad for Apple's translation service. :-)

No, I don't really need the money. I am keeping myself quite busy with reconstructions. Performed 6 big limb reconstruction cases as well as a bilateral CLL fitbone lengthening in the last 10 days (in addition to other surgeries), so am actually too busy for my own good. My reasons for restarting is exactly as I stated in my original post...

With regards to my skills, I am not the best person to judge my own skills. My patients would be in a better position to do so, I guess. :-)

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Highest

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Posted on Jun 18, 2026, 8:37 pm

Hi Dr Franz has nuvasive been in contact with you about when Stryde or its replacement will be on the market again?

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Franz

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Posted on Jun 18, 2026, 8:37 pm

Hi Dr Franz has nuvasive been in contact with you about when Stryde or its replacement will be on the market again?

We are in discussion with them. It is unclear what the timelines would be. It has not cleared all our regulatory hurdles either. So wait and see for now...

We have negotiated a really good deal with Fitbone though and, as you know, they are weight-bearing, so gives us a good alternative at the same price-point.

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Achieverr

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Posted on Jun 18, 2026, 8:37 pm

We are in discussion with them. It is unclear what the timelines would be. It has not cleared all our regulatory hurdles either. So wait and see for now...

We have negotiated a really good deal with Fitbone though and, as you know, they are weight-bearing, so gives us a good alternative at the same price-point.

Hi Dr Franz,

by saying weight bearing nails ? so can they accommodate the same limitations as other mechanical nails ?
what is the possibility of doing the surgery , staying copule of weeks and then flying back home with such nails ?
and from your experience , any case studies or data base as It is first time me hearing about them
Thanks,

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randy

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Posted on Jun 18, 2026, 8:37 pm

What are the weight bearing specifications of Fitbone?

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Franz

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Posted on Jun 18, 2026, 8:37 pm

Fitbone is a motorized lengthening nail developed in Germany and in use since 1997.
Prof R Baumgart is the inventor.
Thousands of these nails have been implanted.
They were originally only available for limited use and were distributed by Wittenstein-Intens.
Recently Orthofix have acquired the rights to manufacture and distribute the device. It has become more widely available.
Quoted weight limitation is 100kg.

https://www.orthofix.com/ifus/fitbone/

Please note: this is for information only. I have no financial interest in the nail or the relevant companies.

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Highest

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Posted on Jun 18, 2026, 8:37 pm

#10

Fitbone is a motorized lengthening nail developed in Germany and in use since 1997.
Prof R Baumgart is the inventor.
Thousands of these nails have been implanted.
They were originally only available for limited use and were distributed by Wittenstein-Intens.
Recently Orthofix have acquired the rights to manufacture and distribute the device. It has become more widely available.
Quoted weight limitation is 100kg.

https://www.orthofix.com/ifus/fitbone/

Please note: this is for information only. I have no financial interest in the nail or the relevant companies.

Am I understanding that this is a full weight bearing nail? As in no Walker or crutches required? Stryde nail was 115 kg post operative weight bearing and this is damn close. How is this not major news?

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Achieverr

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Posted on Jun 18, 2026, 8:37 pm

#11

Am I understanding that this is a full weight bearing nail? As in no Walker or crutches required? Stryde nail was 115 kg post operative weight bearing and this is damn close. How is this not major news?

Fitbone is a motorized lengthening nail developed in Germany and in use since 1997.
Prof R Baumgart is the inventor.
Thousands of these nails have been implanted.
They were originally only available for limited use and were distributed by Wittenstein-Intens.
Recently Orthofix have acquired the rights to manufacture and distribute the device. It has become more widely available.
Quoted weight limitation is 100kg.

https://www.orthofix.com/ifus/fitbone/

Please note: this is for information only. I have no financial interest in the nail or the relevant companies.

Hi Dr Franz,

It is quite confusing actually, as they are mentioning two type of nails I guess based on the patient weight (which is like you said 100 kg) but at the same time in their catalogue mentioned and I quote the follwoing :
"During the active phase and the initial healing phase, the weightbearing capacity of the intramedullary lengthening nail is limited to
partial weight-bearing of 20 kg"
Here is the catalogue :
https://www.orthofix.com/wp-content/uploads/2020/03/Clinician-Guide_FITBONE-TAA_USA-en_Version-012.pdf

Maybe it is them being extra cautious in case any accidental weight bearing and accidental nail breakage so they won't be hold accountable.
appreciate if I can get your thoughts on that

Edit Post

Am I understanding that this is a full weight bearing nail? As in no Walker or crutches required? Stryde nail was 115 kg post operative weight bearing and this is damn close. How is this not major news?

Fitbone is a motorized lengthening nail developed in Germany and in use since 1997.
Prof R Baumgart is the inventor.
Thousands of these nails have been implanted.
They were originally only available for limited use and were distributed by Wittenstein-Intens.
Recently Orthofix have acquired the rights to manufacture and distribute the device. It has become more widely available.
Quoted weight limitation is 100kg.

https://www.orthofix.com/ifus/fitbone/

Please note: this is for information only. I have no financial interest in the nail or the relevant companies.

Hi Dr Franz,

It is quite confusing actually, as they are mentioning two type of nails I guess based on the patient weight (which is like you said 100 kg) but at the same time in their catalogue mentioned and I quote the follwoing :
"During the active phase and the initial healing phase, the weightbearing capacity of the intramedullary lengthening nail is limited to
partial weight-bearing of 20 kg"
Here is the catalogue :
https://www.orthofix.com/wp-content/uploads/2020/03/Clinician-Guide_FITBONE-TAA_USA-en_Version-012.pdf

Maybe it is them being extra cautious in case any accidental weight bearing and accidental nail breakage so they won't be hold accountable.
appreciate if I can get your thoughts on that

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R

randy

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Posted on Jun 18, 2026, 8:37 pm

#12

Yes, I had spoken to a doctor in Europe who said the company officially does not recommend weight bearing.

If I may add, Fitbone is usually put in retrograde in the femurs which is not great for the knees.

Edit Post

Yes, I had spoken to a doctor in Europe who said the company officially does not recommend weight bearing.

If I may add, Fitbone is usually put in retrograde in the femurs which is not great for the knees.

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F

Franz

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Posted on Jun 18, 2026, 8:37 pm

#13

I guess weight bearing is a relative concept. I still let the patient use crutches, but we allow as much weight as the pain will allow.

Edit Post

I guess weight bearing is a relative concept. I still let the patient use crutches, but we allow as much weight as the pain will allow.

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F

Franz

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Posted on Jun 18, 2026, 8:37 pm

#14

There is the guideline that the company gives.
Then there is the guideline that the doctor gives.
Then there is what the patient actually does.

Often these three are not aligned. Having said that, these nails do allow more weight than the original Precice nails and, with the Stryde not currently available to my patients, these nails give a good alternative option.

Fitbone nails are often implanted retrograde for alignment reasons, but can be implanted antegrade as well. The same is true for Precice: they can be inserted either antegrade or retrograde.

Edit Post

There is the guideline that the company gives.
Then there is the guideline that the doctor gives.
Then there is what the patient actually does.

Often these three are not aligned. Having said that, these nails do allow more weight than the original Precice nails and, with the Stryde not currently available to my patients, these nails give a good alternative option.

Fitbone nails are often implanted retrograde for alignment reasons, but can be implanted antegrade as well. The same is true for Precice: they can be inserted either antegrade or retrograde.

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F

Franz

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Posts: 210

Joined: Jun 2026

Posted on Jun 18, 2026, 8:37 pm

#15

Due to the anatomy of the femur it is not really possible to lengthen along the mechanical axis using an antegrade technique.

Fitbone does need surgeons to be trained.

Edit Post

Due to the anatomy of the femur it is not really possible to lengthen along the mechanical axis using an antegrade technique.

Fitbone does need surgeons to be trained.

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F

Franz

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Posts: 214

Joined: Jun 2026

Posted on Jun 18, 2026, 8:37 pm

#16

Just for clarification:

Fitbone allows more weight bearing than the original Precice.

Caution is advised during distraction.

Stryde of course allows unrestricted weight bearing.

It is important to consider that due to pain considerations, full weight bearing during distraction may be difficult anyway.

Edit Post

Just for clarification:

Fitbone allows more weight bearing than the original Precice.

Caution is advised during distraction.

Stryde of course allows unrestricted weight bearing.

It is important to consider that due to pain considerations, full weight bearing during distraction may be difficult anyway.

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H

Highest

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Posts: 29

Joined: Jun 2026

Posted on Jun 18, 2026, 8:37 pm

#17

There is the guideline that the company gives.
Then there is the guideline that the doctor gives.
Then there is what the patient actually does.

Often these three are not aligned. Having said that, these nails do allow more weight than the original Precice nails and, with the Stryde not currently available to my patients, these nails give a good alternative option.

Fitbone nails are often implanted retrograde for alignment reasons, but can be implanted antegrade as well. The same is true for Precice: they can be inserted either antegrade or retrograde.

Do surgeons need special training or permission to use fitbone? Given the amount of patients putting off the surgery until Stryde returns it seems odd more surgeons aren't using this fitbone nail if they can weight bear as tolerated using it.

Why can't surgeons get antegrade insertion to give as good an alignment as retrograde? From what I've read the main issue with retrograde is splitting the patellar tendon which can cause ongoing knee pain.

Edit Post

There is the guideline that the company gives.
Then there is the guideline that the doctor gives.
Then there is what the patient actually does.

Often these three are not aligned. Having said that, these nails do allow more weight than the original Precice nails and, with the Stryde not currently available to my patients, these nails give a good alternative option.

Fitbone nails are often implanted retrograde for alignment reasons, but can be implanted antegrade as well. The same is true for Precice: they can be inserted either antegrade or retrograde.

Do surgeons need special training or permission to use fitbone? Given the amount of patients putting off the surgery until Stryde returns it seems odd more surgeons aren't using this fitbone nail if they can weight bear as tolerated using it.

Why can't surgeons get antegrade insertion to give as good an alignment as retrograde? From what I've read the main issue with retrograde is splitting the patellar tendon which can cause ongoing knee pain.

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T

Thehighest

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Posts: 49

Joined: Jun 2026

Posted on Jun 18, 2026, 8:37 pm

#18

We need more ethical doctors like you, very good you are doing this again to prevent the disasters we have seen

Edit Post

We need more ethical doctors like you, very good you are doing this again to prevent the disasters we have seen

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H

Highest

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Posts: 269

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Posted on Jun 18, 2026, 8:37 pm

#19

Where do your patients typically stay during distraction?

Edit Post

Where do your patients typically stay during distraction?

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A

Achieverr

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Posted on Jun 18, 2026, 8:37 pm

#20

any fears with osteolysis as I understand that Fitbone is stainless steel , won't have a similar problem like the stryde ?

Edit Post

any fears with osteolysis as I understand that Fitbone is stainless steel , won't have a similar problem like the stryde ?

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