Dr Franz Birkholtz (Pretoria, South Africa)

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Quote from: yugiohja on July 10, 2014, 03:11:03 PMHi Dr Franz,
Is there any benefit for bone consolidation if the climate is especially warm/cold or if temperature affects the rate of consolidation at all?

Interesting question. I am not aware of any relationship between temperature and bone consolidation. Because the Ilizarov method was devised in Siberia, maybe cold is beneficial...it could also be the vodka...lol.

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Quote from: CRonnie7 on July 10, 2014, 04:08:53 PMDid you send them Xray already?   If it's PRECISE nail  then they need 4 weeks to order the right size for you.
Jip, our lead time needed for Precice 2 is around 2-4 weeks.

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Quote from: theuprising on July 10, 2014, 09:53:47 PMSorry Dr Franz I should have specified further as to the cost in rand?

Thanks

The cost in rand will essentially be the same as the cost in usd at the current conversion rate. Thw absolute value is a bit difficult to pin down for this reason. Should the patient be a South african, some costs could be saved if they use their own accommodation etc.

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Quote from: ShortyMcShort on July 14, 2014, 07:27:02 AMHi Dr B, Im very curious regarding this method. How long would it take to achieve a goal of 11cms(5 tibia and 6 femur) and how long does a patient need to stay in South Africa for before they can go home and into consolidation? I understand every patient is different but could you give a rough estimate of how much time is needed for this kind of procedure?
Thanks
Essentially the minimum time in SA would be 90 days, which is the same as for the precice 2 bilateral femorals. The patient could then go home and consolidate and return for the opposite combination after around 9 months. The femur must be strong enough to carry full weight. In total, I think the shortest time to reasonable recovery should be around 18m-2yrs.
Cost will be in the region of 42K USD per step, ie a total of 84K for all 4 segments.

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Thanks for the quick reply Dr B, one last question. What are the advantages of doing it that way over say Precice femur(both femurs) first and then going home to consolidate and then coming back a year or so later to do the tibias? Could a precice femur patient be able to come back and do their tibias after 9 months as well? Theoretically speaking of course

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Quote from: ShortyMcShort on July 14, 2014, 11:48:43 PMThanks for the quick reply Dr B, one last question. What are the advantages of doing it that way over say Precice femur(both femurs) first and then going home to consolidate and then coming back a year or so later to do the tibias? Could a precice femur patient be able to come back and do their tibias after 9 months as well? Theoretically speaking of course
The biggest advantage would be the ability to weight bear on the exfix side theoretically.
Jip if the bone growth is good.

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Hello Dr. B. Hope you're having a good day. I was wondering if, should a CLL patient have a natural tibia/femur ratio of 0.8, they should lengthen their tibiae or femurs to have better athletic recovery and favorable walking mechanics. How far beyond the 0.8 ratio can patients go, generally speaking with regards to single segment lengthening of femur or tibiae, before mechanics start to suffer and arthritis becomes a concern?

Thank you.

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Quote from: Tall on July 16, 2014, 06:33:14 PMHello Dr. B. Hope you're having a good day. I was wondering if, should a CLL patient have a natural tibia/femur ratio of 0.8, they should lengthen their tibiae or femurs to have better athletic recovery and favorable walking mechanics. How far beyond the 0.8 ratio can patients go, generally speaking with regards to single segment lengthening of femur or tibiae, before mechanics start to suffer and arthritis becomes a concern?

Thank you.
Thanks. I did have quite a busy day with 7 operations, but am able to relax now.
I am not aware of a lot of scientific literature on the topic.
It is however true that visually, tibial lengthening has more of an effect. Ie tibial lengthening looks longer than femoral.

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For most people a 5cm tibial lengthening should not result in major functional longterm issues, as the ratio is changed from around 0.8 to 0.95.

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Hi Dr. Franz,
Often, I wonder if when I undergo LL, I'm putting myself in a situation where even a slight waver of the surgeon's hand can leave a life-long impact on my legs. 
Is this true to an extent?
You say you did 7 surgeries in a single day, and I wonder if a surgery is a "monotonous" job.

If I went to a "hair dressing machine" that did a fixed hair-style, I wouldn't feel scared even if I have to live that hair-style for the rest of my life (and my hair won't grow back, say ). It is monotonous to the machine, and I wouldn't think anything would go wrong.

But if is a barber who's doing it routinely on a large chain of people, I would have my fears.

poor example, but I hope you got my point.
What is your take on this?