Hello Dr. Birkholtz. I have a question for you, if you don't mind.
During your time practicing and studying orthopedic medicine, how much variation in the following proportional ratios have you seen between your patients?
Leg to upper body height ratio
Femur to tibia ratio
Femur to torso ratio
Thank you very much for your time.
Quote from: Sweden on November 15, 2013, 02:50:01 PMBc it's Africa. Nobody has any idea of what they're doing.
What sane person goes to Africa?
SOUTH Africa. It's a developed, relatively-peaceful country--especially the big cities. It would be ridiculous to compare South Africa to undeveloped rest of Africa.
I like this doctor very much.
Why
Quote from: axelf on February 20, 2015, 05:55:37 PMWhy
BEcause of his relatively good prices and his good answers at the forum. This is an option to consider.
Quote from: ReadRothbard on September 30, 2014, 08:06:28 PMSOUTH Africa. It's a developed, relatively-peaceful country--especially the big cities. It would be ridiculous to compare South Africa to undeveloped rest of Africa.
people think Africa as a continent is undeveloped.. S. Africa a developed nation? or is it developing and close to developed...?
Quote from: ItsMyLife on February 20, 2015, 07:49:52 PMpeople think Africa as a continent is undeveloped.. S. Africa a developed nation? or is it developing and close to developed...?
I don't know much about South Africa but I think it's pretty developed.
Quote from: Franz on February 24, 2015, 02:35:17 PMHi,
I am not aware of any data to suggest that it is purely due to the ratio change. I think it is more the muscle length changes as well as the surgical trauma. If this is the case, athletic ability will worsen with further surgery.
Not sure this is the aswer you wanted, though!
Hi Doctor,
My Russian doctor initially suggested me to do femur + tibia. But once he learnt I could be happy with 8 cm, he said I would have greater athletic recovery with 8 cm tibia (even though my femur-tibia ratio would be very close to 1); at first, he said 7-8 cm tibia, 4 cm femur. But now, he seems reluctant to do femur if I wanna retain athleticism.
In other words, it seems you agree with him:
1. minimise surgical trauma - avoid a second surgery
2. the ratio may not be that important
3. minimise muscle and soft tissue changes by avoiding 2nd surgery
Of course, no studies are done, but this is what you think?
Am I right?
I know you said not to exceed 5 cm but I am now at 5.2 with no soft tissue problems or much pain or sleep problems.
Quote from: Franz on February 24, 2015, 02:35:17 PMHi,
I am not aware of any data to suggest that it is purely due to the ratio change. I think it is more the muscle length changes as well as the surgical trauma. If this is the case, athletic ability will worsen with further surgery.
Not sure this is the aswer you wanted, though!
Thanks for the reply. I'd much rather have the honest information over what I would ideally like to hear. I'm kind of happy that there's more reason for me to not have to go through this again. 
Hi guys,
We've looked at the numbers again. There is currently a lot of volatility in the international currency exchange rates. For this reason we have decided to change our costing model so that the quoted price is in South African Rand (ZAR). We pay the subcontractors in Rand so it makes sense to peg the price locally. This will obviously make our prices more competitive to some people and less so to others.
Secondly, we have started a second office at the brand new state of the art Mediclinic Midstream Hospital with fantastic facilities. We will be offering our CLL services at this hospital. It is more upmarket and discreet. The price quoted is for a private room in this facility (flat screen tv, private bathroom etc).
Remember that although we are getting progressively more known for internal lengthening with Precice, we have had many years of experience with the Ilizarov method, Taylor Spatial Frame, Truelok and Truelok Hex frames as well as other techniques. Therefore we can offer a high level of expertise and care should you require external fixator based treatment.
Lastly, we have decided to include all medical related costs into our package price estimates, but to leave accommodation costs out for now. The issue with accommodation is that the cost can vary widely depending on the option chosen. We can however put you in touch with relevant facilities that provide accommodation services.
The package includes:
- all hospital fees
- surgeon, assistant and anaesthetic fees
- prosthesis (implant) fees
- multidisciplinary team support
- physio daily in hospital and 3-5 days per week as outpatient
- regular doctor and nursing follow ups
- xray follow ups
- walking frame and wheelchair rental
For Precice 2 femorals it works out to 550K ZAR. Current exchange rate = 45800 USD.
Externals only: 300K ZAR. Current exchange rate = 25000 USD.
LON/LATP: 400K ZAR. Current exchange rate = 33000 USD.
I hope this clears up some confusion.
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