Q & A With Dr Franz Birkholtz

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Quote from: Uppland on October 12, 2015, 10:47:34 PMDr. 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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Quote from: Franz on October 15, 2015, 02:23:18 PMThanks for the kind words. If we think of the worst case scenario for CLL, it is probably severe functional loss of the affected limb(s). Loss of function in the lower limb is generally much better tolerated than losing function of arms or hands. For this reason CLL in the lower limb is more acceptable than in the upper limb.
 The bone growth that occurs during humerus lengthening is generally good and the soft tissues adapt reasonably well. The major issue is potential for nerve damage and diminished hand function.

Range of motion of the joints are affected during CLL (even though the effect may be slight). Muscle length and power changes permanently. Loss of flexibility and explosive power. Loss of some proprioceptive capacity. Endurance loss. How much is lost and how much it will affect each individual is quite difficult to ascertain, but there seems to be a roughly linear relationship between these factors and the amount lengthened. Ie, the more you lengthen, the more of these you can expect.

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Quote from: Franz on October 15, 2015, 02:23:18 PMThanks for the kind words. If we think of the worst case scenario for CLL, it is probably severe functional loss of the affected limb(s). Loss of function in the lower limb is generally much better tolerated than losing function of arms or hands. For this reason CLL in the lower limb is more acceptable than in the upper limb.
 The bone growth that occurs during humerus lengthening is generally good and the soft tissues adapt reasonably well. The major issue is potential for nerve damage and diminished hand function.

Range of motion of the joints are affected during CLL (even though the effect may be slight). Muscle length and power changes permanently. Loss of flexibility and explosive power. Loss of some proprioceptive capacity. Endurance loss. How much is lost and how much it will affect each individual is quite difficult to ascertain, but there seems to be a roughly linear relationship between these factors and the amount lengthened. Ie, the more you lengthen, the more of these you can expect.

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Quote from: Uppland on October 15, 2015, 11:15:33 PMOne last question if I may:

I plan to lengthen my femurs 5CM via an internal nail method, how do I as a patient best prepare for this surgery?

I already try to stretch and build my leg muscles, is there anything else and do you have any tips?

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Quote from: Alu on October 15, 2015, 11:36:13 PMDr.Franz,

I certainly don't mean to negate your comments, considering that the humerus is as an important limb to hand as the spine is to the nervous system, but wouldn't those functionality comments be more applicable to the forearm. It seems like overall forearm lengthening would be the one most impacting the functionality of the hand. Also I do recall this study saying it'd be the easiest to lengthen out of all the possible segments; this of course doesn't mean it wouldn't actually effect functionality, but I digress:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2323419/

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Quote from: KiloKAHN on October 19, 2015, 07:58:20 PMHi Dr Birkholtz,

It seems that most who use the Precice for femur lengthening perform an ITB release whereas the well-known surgeons who use an Albizzia nail choose not to do one. Is the ITB release done to make it easier for the Precice to distract? What would the consequence(s) be if one were to lengthen femurs without an ITB release done?

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Quote from: Nightwish on October 19, 2015, 08:16:14 PMHi Dr Birkholtz,

I would also like to echo Uppland's sentiments regarding your contribution to this forum and the awareness you've raised regarding this surgery.

I am wondering what your views are on the surgery being done over two stages, eg right leg first then the left after the right leg can be used again.

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