Dr Birkholtz
I am looking my femurs internally . I am looking to lengthen 2 inches.
How long would it take to recover from the day of surgery all the way to doing sports again specifically soccer and basketball. And would I be able to go back to 100 percent athletic abilities?
Quote from: onemorefoot on February 08, 2017, 03:59:36 AMThank you very much for your time, Dr.
No worries
Quote from: jbc on February 08, 2017, 04:31:27 AMDr. Birkholtz, thank you for returning to the forum! I would certainly appreciate your take on the following questions:
1) Do you believe that a biceps femoris release is required for femoral lengthening? Some Drs perform it as a precautionary measure, some do not - I would love your opinion on this, and specifically, what the tradeoffs are in performing/not performing the release?
2) What do you consider a "safe" lengthening amount for close to full return to athletic activity? Reading through literature, you and other Drs have stated 5 cms, possibly 6 cms. Are there specific medical/physiological reasons as to why this is considered a "safe" length, and/or is there more leeway between a person of, say, 168 cms in stature vs one of 178 cms in stature (leaving aside the why the taller person would seek the procedure)?
The latter seems to be a pretty common question on the board, I'm not sure I've seen it answered in great detail.
Your time here is very much appreciated. I am actually glad you are being bombarded by inquiries 
, based on your reputation, you seem to be a terrific surgeon and clinician, and I hope your CLL practice continues to blossom. TIA.
Hi, thanks for the kind words.
Biceps femoris lengthening is not something I do often and my suspicion is that with my conservative lengthening goals, we probably need it less often than with surgeons who routinely push to 8cm. ITB release, on the other hand, is something I think is essential in nail based femoral lengthening. This helps nail elongation and does not seem to cause any long-term effects.
The issue with a discussion around safe lengthening amounts is that the complications as well as athletic ability are so variable per patient and that many individual factors contribute. As a rule, we start seeing more complications of regenerate delayed unions, deformities, muscle contractures etc after around 5 cm. That is where that comes from. Of course the athletic recovery is dependent on a number of factors like: -pre-surgery athletic ability ; -lengthening amount (this affects the lever arms and mechanics, as well as muscle tightness) ; -muscle tightness and contracture which is also is indirectly related to lengthening amount ; -alignment after lengthening ; and postoperative rehabilitation.
In general, we can probably ironically get a bit more length safely in a patient with a longer starting height than in someone who starts out shorter. It is a precentage equation. So, again, the guys who need the most length are ironically again the guys in whom we can probably safely add less. Just life, I guess?
Quote from: MyronReducto on February 08, 2017, 04:51:53 AMDr.Birkholtz
Thank you very much for your contribution to this forum.
Would the benefits outweigh the risks of nail removal, femur PRECICE2 in particular?
Good question. We simply do not know what the long-term effects of those magnets are. Furthermore MRI is impossible with those nails in.
For these reasons it is advisable to have them removed. The issue is that it is surgery again and that it may well end up with slightly larger scars as well. Ironically the wounds used to remove the nails are typically larger than to insert them.
Quote from: yyes on February 08, 2017, 05:20:48 AMDr Birkholtz
I am looking my femurs internally . I am looking to lengthen 2 inches.
How long would it take to recover from the day of surgery all the way to doing sports again specifically soccer and basketball. And would I be able to go back to 100 percent athletic abilities?
50mm lengthening:
10 days lag period, 50 days distraction period. Ie 2 months till length is achieved. Bone consolidation typically takes another 4 months. Ie by six months full unaided weight bearing should be OK. Return to sport the six-nine months after that, depending on the type of sport.
Ballpark is around 18 months.
Hello doctor Franz.
I wanted to ask, is there a reason that both you and dr.Rozbruch now more "easily" accept people taller than below the 3%? Before, only a handful of docs accepted people of certain heights (my 5'7 included) but now it seems doctors are more open to do the operation on taller folks (I presume based on the risk/reward ratio).
Basically, what I am asking is if the new methods really did "revolutionized" LL in terms of safety? Did the precise nail really made the procedure much more safer, thus making more doctors feel more comfortable doing this procedure on even taller (sane minded) folks?
Hi Dr. Franz, thanks so much for answering our questions. I'm interested in your quote about the ITB release. What exactly is an ITB release? What happens to the band after? Does it go back to normal?
Quote from: Franz on February 08, 2017, 01:31:50 PMITB release, on the other hand, is something I think is essential in nail based femoral lengthening. This helps nail elongation and does not seem to cause any long-term effects.
Quote from: TIBIKE200 on February 08, 2017, 03:08:08 PMHello doctor Franz.
I wanted to ask, is there a reason that both you and dr.Rozbruch now more "easily" accept people taller than below the 3%? Before, only a handful of docs accepted people of certain heights (my 5'7 included) but now it seems doctors are more open to do the operation on taller folks (I presume based on the risk/reward ratio).
Basically, what I am asking is if the new methods really did "revolutionized" LL in terms of safety? Did the precise nail really made the procedure much more safer, thus making more doctors feel more comfortable doing this procedure on even taller (sane minded) folks?
Good observation. I think you are hitting the nail on the head (excuse the pun). As techniques and technologies evolve, surgical indications also evolve.
Quote from: Franz on February 08, 2017, 06:53:59 PMGood observation. I think you are hitting the nail on the head (excuse the pun). As techniques and technologies evolve, surgical indications also evolve.
So indeed we can safely say that LL is much more safer today than even 5 years ago?
Hi Dr Birkholtz,
When you first obtained access to the Precice nail, was a representative from Ellipse sent by the company to be present during the surgeries? If so, how long does that continue until Ellipse decides that a representative doesn't need to be there for the surgery every time you use it on a patient?
You must be logged in to post a reply.
