Q & A With Dr Franz Birkholtz

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Posted on Jul 7, 2014, 8:07 pm

#61

Quote from: Wannabegiant on June 27, 2014, 03:18:16 PMInteresting, about how long after frame removal are you allowed to jump? similar timeframe as running? (external only)
And what about working out the legs, doing leg press etc?

Also we have a diary here of a patient who did 9 cm in 10 months externals only, so with that in mind i assume it is possible but uncommon to heal faster than 1.5 - 2 months per cm. Since 9 cm in 10 months is ca 33 days per cm, ie slightly more than a month/cm

Thank you for all the info Dr. Franz

I allow full weight bearing from day one as much as the patient can tolerate. If you want to jump, you are welcome to (as long as it is not off a buiding! :-). Generally I would say that jumping comfortably would be similar to running.
Our fastest healers have been at just below 1 month per cm (28 days), but the average is around 1.3 - 1.5. Not to create false hope, we add another 0.5.

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KiloKAHN

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Posted on Feb 23, 2015, 9:21 pm

#62

Hi Dr Birkholtz,

Is the loss of athletic ability after limb lengthening influenced more by the stretching of the soft tissues or more so the change in ratio between tibs/femurs? Or is it just the surgical trauma? I guess what I'm wondering is if a loss of athletic ability after one lengthening can be minimized by lengthening a second segment and getting the ratio between femurs/tibs closer to what they were originally. Or would a second lengthening just cause a further dip in athletic ability because of the additional surgical trauma?

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Franz

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Posted on Feb 24, 2015, 2:35 pm

#63

Quote from: KiloKAHN on February 23, 2015, 09:21:10 PMHi Dr Birkholtz,

Is the loss of athletic ability after limb lengthening influenced more by the stretching of the soft tissues or more so the change in ratio between tibs/femurs? Or is it just the surgical trauma? I guess what I'm wondering is if a loss of athletic ability after one lengthening can be minimized by lengthening a second segment and getting the ratio between femurs/tibs closer to what they were originally. Or would a second lengthening just cause a further dip in athletic ability because of the additional surgical trauma?

Hi,

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!

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Franz

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Posted on Oct 12, 2015, 7:34 pm

#64

Hi guys,

I have decided to montior this thread in the interest of safety and accurate information. Please note that in the interest of not appearing to promote myself, I will not enter into any discussions about finances in this thread. For any specific or cost-related queries, please email me at [email protected].

Realistically I will probably only be able to monitor and reply once a week.

Warm regards,

FFB

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Alu

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Posted on Oct 12, 2015, 9:11 pm

#65

Well to (re)start things off:

As of now how many CLL have you done with the PERCICE 2?
How has the process been for these patients?
Have you kept in touch with any of your former patients; have any newly unreported long term complications arisen since this time?
Would you say that there should be a possible limit on the amount done with regards to tibia? Like say 5 cm?

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theuprising

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Posted on Oct 12, 2015, 9:35 pm

#66

Quote from: Alu on October 12, 2015, 09:11:30 PMWell to (re)start things off:

As of now how many CLL have you done with the PERCICE 2?
How has the process been for these patients?
Have you kept in touch with any of your former patients; have any newly unreported long term complications arisen since this time?
Would you say that there should be a possible limit on the amount done with regards to tibia? Like say 5 cm?

If possible could there be a reply about the long term complications of going over the recommended amounts as it gets asked on here constantly. Example will a guy who does 9cm on one segment eventually recover the same in the end as a guy who did 5cm? What do these big lengthening do to the body so it doesn't totally recover the same?

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Uppland

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Posted on Oct 12, 2015, 10:47 pm

#67

Dr. franz your commitment to providing safe and accurate information to us potential patients is as amiable as your knowledge and friendly attitude.

-You stated earlier that cosmetic humerus lengthening isn't recommended could you expand on why that is, which complications that tend to occur and if there are exceptions to this rule?

-Could you speak in more general terms about the permanent loss of athletic function that most if not all LL patients experience? I'd like to better understand the long-term effects on my body.

Thank you so much.

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KiloKAHN

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Posted on Oct 12, 2015, 11:20 pm

#68

Good to see Dr Birkholtz back.

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Franz

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Posted on Oct 15, 2015, 2:12 pm

#69

I have now done 3 cosmetic limb lengthenings with Precice 2. Our overall Precice experience is now over 15 nails. External fixator based lengthenings more than 1500.

As far as I am aware, none of our CLL Precice patients have had significant complications in the long term.

Tibial CLL should probably be limited to around 4-5cm. This has to do with muscle tension and contractures primarily. Although the muscles to grow in the process of distraction histogenesis, there is an element of stretching that has to take place as well and if this is excessive, contractures result (eg ballerina foot) and this may be permanent.

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Franz

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Posted on Oct 15, 2015, 2:16 pm

#70

Quote from: theuprising on October 12, 2015, 09:35:44 PMIf possible could there be a reply about the long term complications of going over the recommended amounts as it gets asked on here constantly. Example will a guy who does 9cm on one segment eventually recover the same in the end as a guy who did 5cm? What do these big lengthening do to the body so it doesn't totally recover the same?

See my previous post. it primarily has to do with the amount of stretching and tension exerted over a muscle tendon unit. If you exceed the 'safe distance', you may well end up with permanent contractures. This means that you lose joint movement. Of course longer distractions take more time, have higher non-union rates, are more painful etc etc (see previous posts in this thread).

A 5cm lengthening may recover full function over time, a 9cm one is much less likely to do so.

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