Quote from: chasing_higher_dream on March 13, 2021, 10:01:58 PM@maximize Yes, my consultation started at 3 pm and it lasted till 7.30 pm. I presume this much amount of time is normal with his consultation.
During this consultation below points were covered:
- X-rays were taken
- Height and wingspan were measured
- With help of software simulation images were shown how I would like at 4 cm, 6 cm, 8 cm, and 10 cm lengthening.
- Explanation of how the femur and tibia bone looks like along with the surrounding tissues.
- Explanation of how my bone looks in X-rays and also the ratio between tibia and femur.
- Explanation of femur vs tibia lengthening
- Different nails in the market and the differences between them (of course Dr. Betz was showing great confidence in Betzbone). According to Dr. Betz, the only competitor he sees to Betzbone nail is Stryde. He also said that Betzbone has a very high resistance to rusting and he did not have any case of rusting on his nails till now.
- Size of the nail which would be suitable for my bones. Dr. Betz said he does not like to ream the bone canal too much with bigger diameters.
- Short overview of how the surgery would look like on the femur.
- Stories from his past patients who lengthened 7 cm, 8 cm, 10 cm, and one guy even lengthened 12 cm (the max you can go with Betzbone)!!! He did say that he does not recommend lengthening to this amount and he recommends his patients to stay under 8 cm. Max 10 cm.
- Gist of how the lengthening phase would look like. He said he is available for all his patients via Whatsapp whenever possible.
- I also asked Dr. Betz whether he does IT band release? And he said he does not do IT band release. When I asked him the reason for not doing it, it was along the lines that it may cause problems in long run. He said that with proper PT, the IT band should stretch over the period of months, though this make take a considerable amount of time.
- And lastly, all the complications which may occur and all the preemptive measures he takes to prevent them.
We may have discussed more, but right now I do not recall everything.
At the end of the consultation, I was almost out of questions but Dr. Betz was like take your time and think if you want to ask something more.
But finally, I decided that this was all I had to ask, I thanked him, and then exited his clinic.
Wow that is really great that he is so thorough with you. And thanks for the long answer. I think I would really like a consult with him, if nothing else just to pick his brain. I personally agree with him 100% about IT band releases and not reaming too much. If you ream too aggressively you will weaken the bone. And I have always been leery about unnecessary soft tissue releases. I agree everything should stretch over time.
I just read through some of the negative threads about Betz and most of them seem to be about nonunions. I summarized my perspective here:
http://www.limblengtheningforum.com/index.php?topic=66343.msg190462#msg190462
In short, we know there is a risk with ratcheting nails like Betz/Guichet's, because they cannot close down if you open them too quickly. But as I see it, this risk should be controllable just by going slower with careful xray monitoring to ensure callus is forming or bridging is maintained in the gap. As long as you always see that there should be no significant risk.
Did you get to talk to Betz about how he tries to avoid nonunion or what he aims for in terms of x-ray monitoring through the distraction phase? ie. How often x-rays? What is he looking for? How much of a gap is he comfortable with when there is no visible callus? etc.
If not, I expect you will have to review that either way before you go home and I'd appreciate you letting us know what he says. Thanks again.
