Long frame times do not necessarily equate to permanent muscle damage. We encourage early functional rehab including full weight bearing which promotes muscle function.
New bone (regenerates) are often wider than the original bone. This is a good thing. It means your surgeon knows what he's doing and you're creating good quality bone. Will have no effect on function.
Quote from: Franz on November 26, 2013, 09:28:21 PMLong frame times do not necessarily equate to permanent muscle damage. We encourage early functional rehab including full weight bearing which promotes muscle function.
New bone (regenerates) are often wider than the original bone. This is a good thing. It means your surgeon knows what he's doing and you're creating good quality bone. Will have no effect on function.
Thank you 
Dr. Birkholtz-
I have a honest and direct statement and question for you. I believe it is a big mistake to restrict who you perform cosmetic limb lengthening on based on the patients starting height. Doctors such as yourself who focus on patient safety and not money or self promotion are exactly the kind of doctors that need to be performing this surgery for patients. This surgery is loaded with money grubbing salesmen of doctors (Dr. Betz, Dr. Mahboubian,) just to name of few who use people on old forums to promote them and their business. Without doctors like you who focus on patient safety people interested in this surgery have very few safe affordable options. Now that a nail like the Precice is available that offers a much more cosmetic experience compared to external fixation will you consider offering your services to people of all heights?
Quote from: handy on November 27, 2013, 05:14:24 AMDr. Birkholtz-
I have a honest and direct statement and question for you. I believe it is a big mistake to restrict who you perform cosmetic limb lengthening on based on the patients starting height. Doctors such as yourself who focus on patient safety and not money or self promotion are exactly the kind of doctors that need to be performing this surgery for patients. This surgery is loaded with money grubbing salesmen of doctors (Dr. Betz, Dr. Mahboubian,) just to name of few who use people on old forums to promote them and their business. Without doctors like you who focus on patient safety people interested in this surgery have very few safe affordable options. Now that a nail like the Precice is available that offers a much more cosmetic experience compared to external fixation will you consider offering your services to people of all heights?
Thanks for your kind words.
I get your point and accept that as complication rates drop, we can extend the indications. It is something that could be considered in the right individual, so I probably would not advocate it widely.
Quote from: Franz on December 03, 2013, 02:20:46 PMHi there, again a good question.
In adults the long bones have very little functioning (blood-forming) marrow left, and it is basically a fat-filled cavity. Whereas this fat is not so important, what is important is that there are blood vessels that feed the bone itself in this cavity. Of course when we ream and stick a nail in there, it destroys some of the blood vessels. Hence some of the complications like delayed and non-unions we sometimes see with intramedullary nails. Once the nails are removed, the endosteal (marrow cavity surface) blood vessels are restored somewhat.
All of this is uncanny, but does not seem to translate into significant complications or problems in most individuals.
The more important potential risk involved with reaming is that of fat embolism. This is where fat is displaced into the blood stream during reaming and can cause significant respiratory problems. There are techniques to reduce this risk. Discuss this with your doctor, and if he does not know how to do this, look elsewhere. This complication can be fatal in rare instances.
The idea is not to scare you, but to give you as much info as you need to make safe decisions...
Hope this helps!
Warm regards.
It sounds like the ROD can cause a lot of issues, suppose I wanted 5cm. And I did external only. If I have a favorable LL experience, what kind of recovery time frame would I be looking at? What would a price from a doctor like yourself be for external Illzarov only?
Quote from: Franz on December 03, 2013, 07:23:34 PMApart from the reaming and potential infection risks, tibial nails have around a 50% chance of persistent knee pain. Only half of these patients improve when nails are removed.
These are the kind of statistics we need to hear but never do! You will never read something like this on old forum or hear it from other doctors. But if you read any diary there, you'll easily see what he's saying is true.
Quote from: Franz on December 03, 2013, 07:23:34 PMApart from the reaming and potential infection risks, tibial nails have around a 50% chance of persistent knee pain. Only half of these patients improve when nails are removed.
Do you know why knee pain would persist even after the nails are taken out?
Quote from: BilateralDamage on December 03, 2013, 08:27:08 PMThese are the kind of statistics we need to hear but never do! You will never read something like this on old forum or hear it from other doctors. But if you read any diary there, you'll easily see what he's saying is true.
Another reason why "promoting" leg lengthening to be available to everybody who wants it is a bad idea, imo. So many people will jump into the thought of CLL with just the thought of getting taller but have little idea of what can potentially go wrong with them. In a way I think the relative obscurity of the procedure is for the best.
Quote from: Medium Drink Of Water on December 03, 2013, 08:52:08 PMDo you know why knee pain would persist even after the nails are taken out?
Nobody really seems to know. Initially we thought it may have do do with whether you split the patella tendon to insert the nail. Going through or next to the tendon does not seem to make a difference though.
It probably is multifactorial, but may have something to do with the change in threedimensional architechture of the proximal tibia as a result of the nail. Put in layman's terms: it's probably because we make a huge hole and shove a piece of metal down it!
Quote from: Kilokahn on December 03, 2013, 08:55:24 PMAnother reason why "promoting" leg lengthening to be available to everybody who wants it is a bad idea, imo. So many people will jump into the thought of CLL with just the thought of getting taller but have little idea of what can potentially go wrong with them. In a way I think the relative obscurity of the procedure is for the best.
With regards to an earlier question you asked...do you now see why I am so careful about CLL?
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