Dr Franz Birkholtz (Pretoria, South Africa)

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Quote from: theuprising on May 21, 2014, 08:16:59 AMHello again Dr B, after lengthening is complete do you remove the nails or plates from the body. If so is this a separate cost?
Its better to remove the nails, as we do not know what the longterm effects of the precice magnets would be. The nail also has moving parts which conceivably could cause metal debris theoretically. Plates I would leave up to the patient to decide.
Cost for removal around 2K USD at the day surgery clinic.

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do you know how much do you have to wait before u're able to run if u do 5cm on tibiae with ilizarov external device, and also for lengthening and consolidation how much should I expect ( 8 months?)

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can you please answer to me franz?

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Quote from: Hallijah on May 25, 2014, 08:28:08 AMdo you know how much do you have to wait before u're able to run if u do 5cm on tibiae with ilizarov external device, and also for lengthening and consolidation how much should I expect ( 8 months?)
Lengthening and consolidation in externals takes 1.5 - 2 months per cm. this means 7.5 - 10 months in frames.
Comfortable running should be possible 6-9 months after frame removal, but is difficult to predict.

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Dr Franz I'm curious to get your opinion on lengthening two segments at once on the same leg e.g tibia+femur on right leg while weight bearing
on the left then proceeding to lengthen the left after the right leg has sufficiently healed as some Doctors suggest.

Also do you accept payment in rand?

 

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Quote from: theuprising on July 04, 2014, 09:29:45 AMDr Franz I'm curious to get your opinion on lengthening two segments at once on the same leg e.g tibia+femur on right leg while weight bearing
on the left then proceeding to lengthen the left after the right leg has sufficiently healed as some Doctors suggest.

Also do you accept payment in rand?

 
We do accept Rands. It has Mandela's face on it afterall! The reason we quote in USD is that it is more universally used...

Two possible scenarios: do one side first, ipsilateral femur and tibia. Good, but will result in a leg length discrepancy until the second side is done. If the second side is never done because of pain, finances etc, it means we have turned you into a 'cripple'.
The second scenario (preferred), is to perform femoral precice on the one side with an exfix tibial lengthening on the other of roughly equal amounts. This means the overall leg lengths stay the same throughout and the exfix leg becomes the weight bearing leg. Again, if we do not proceed with the second phase, the knees will end up on different levels, but at least the legs will be roughly equal in length.

If a patient is very committed I would choose the second option.

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Quote from: Franz on July 07, 2014, 08:07:46 PMI allow full weight bearing from day one as much as the patient can tolerate. If you want to jump, you are welcome to (as long as it is not off a buiding! :-). Generally I would say that jumping comfortably would be similar to running.
Our fastest healers have been at just below 1 month per cm (28 days), but the average is around 1.3 - 1.5. Not to create false hope, we add another 0.5.

Ah I see!

Just to make sure im not misinterpreting you, do you mean that after the frames have been removed, it is already possible to run and jump from day one? but "comfortable" running will be possible on average after 6 months after frame removal like you mentioned earlier?

is this because of muscle atrophy and the body needing to relearn how to run the reason why running comfortably takes so long after frame removal?

Thank you again Dr Franz!

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Quote from: Wannabegiant on July 07, 2014, 08:15:02 PMAh I see!

Just to make sure im not misinterpreting you, do you mean that after the frames have been removed, it is already possible to run and jump from day one? but "comfortable" running will be possible on average after 6 months after frame removal like you mentioned earlier?

is this because of muscle atrophy and the body needing to relearn how to run the reason why running comfortably takes so long after frame removal?

Thank you again Dr Franz!
It is so difficult to predict exactly, but I would certainly allow a patient to run on a fully conslidated bone. Whether it would be comfortable is an entirely different question...

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Quote from: Franz on July 07, 2014, 08:26:56 PMIt is so difficult to predict exactly, but I would certainly allow a patient to run on a fully conslidated bone. Whether it would be comfortable is an entirely different question...

Okey i understand what youre saying 

Im just confused because my own doctor (or his assistant rather) told me that the bone wouldnt exactly be 100% consolidated until about 6 months to a full year after frame removal, but strong enough to walk on the day they remove the frames.

And they adviced me not to do sports or work out the legs like doing legpress until the bone was strong enough, apparantly according to them it isnt strong enough for those activities when they remove the frames.

I didnt get an specific answer from them (its hard because they dont speak english very well) but i assume i would risk a fracture if i didnt follow those instructions, maybe even lose height due to compression? (like subsidence maybe?)

Sorry for making the question so convoluted, but im very paranoid about this stuff, thank you again for your help  Dr. Franz

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What time of year do you think it's best to come to Pretoria based on weather? I heard south africa is hot but if I come for consultation I'd like it to be in the cooler months.