Small LLD correction with Dr. Rozbruch

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WHat did HSS CEO say Hamza?

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Quote from: Infinity on September 18, 2019, 08:25:43 AM@Hamza please take another opinion or two if you feel the need to do so, there is no harm in it but you dont need to travel to do so as this can be done simply via emails. Although i think you are on the right track but only thing i will suggest is that you can do this surgery relatively cheaper with a good orthopedic surgeon in europe who specializes in lower limb deformities rather than going to someone like betz (who i still believe is an excellent surgeon) as i think both him and guchiet are not very ethical surgeons and charge too much as they are used to doing CLL, hence their prices are very high.

IMO it should not cost you more than 10-12K euros to get it done with a respectable surgeon in one of the EU countries.



Infinity,

I emailed Dr Betz yest. and asked about acute lengthening of 1 cm if it does result in nerve damage he said definitely it wont.
I emailed yest. another Dr in Europe and i am waiting his answer (third opinion).

I agree with u that with normal orthopedic surgeon the cost will be less but dont u think that it is safer to go for this small correction with doctors that are specialized and have a lot of experience in limb lengthening ? specially because i already inserted a nail and now i need to exchange it so these Dr s deal with a lot with similar cases ... what do u think ?

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Quote from: Hamza on September 19, 2019, 05:08:34 AM

Infinity,

I emailed Dr Betz yest. and asked about acute lengthening of 1 cm if it does result in nerve damage he said definitely it wont.
I emailed yest. another Dr in Europe and i am waiting his answer (third opinion).

I agree with u that with normal orthopedic surgeon the cost will be less but dont u think that it is safer to go for this small correction with doctors that are specialized and have a lot of experience in limb lengthening ? specially because i already inserted a nail and now i need to exchange it so these Dr s deal with a lot with similar cases ... what do u think ?

@Hamza
The danger of nerve damage or problems normally start after 3-4 cm mark and as i understand it 1 cm (even if it was done all togather) does not pose any danger to nerve or ligament damage. At worst it will just makes you uncomfortable for few days.

Please understand that CLL surgeons are not better than deformity/correction surgeons, they just have more experience delaing with bilateral Cosmetic LL cases. In your case its not bilateral lengthening and its definitely not CLL, in my opinion yours is a straight forward case LL discrepancy correction which can and should be corrected with acute lengthening and than nailing allowing you to get on with your life. This can be done by ANY respectable experienced lower limb deformity correction surgeon even in your home country. Here the key is to look for surgeon who is experienced in lower limb correction surgeries.

This is not a medical advice as i am not qualified to do so and the decision is yours as its your money and legs. Do what you feel most comfortable with.

Good Luck.

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Quote from: Infinity on September 20, 2019, 11:30:24 AM@Hamza
The danger of nerve damage or problems normally start after 3-4 cm mark and as i understand it 1 cm (even if it was done all togather) does not pose any danger to nerve or ligament damage. At worst it will just makes you uncomfortable for few days.

Please understand that CLL surgeons are not better than deformity/correction surgeons, they just have more experience delaing with bilateral Cosmetic LL cases. In your case its not bilateral lengthening and its definitely not CLL, in my opinion yours is a straight forward case LL discrepancy correction which can and should be corrected with acute lengthening and than nailing allowing you to get on with your life. This can be done by ANY respectable experienced lower limb deformity correction surgeon even in your home country. Here the key is to look for surgeon who is experienced in lower limb correction surgeries.

This is not a medical advice as i am not qualified to do so and the decision is yours as its your money and legs. Do what you feel most comfortable with.

Good Luck.

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Quote from: Infinity on September 20, 2019, 11:30:24 AM@Hamza
The danger of nerve damage or problems normally start after 3-4 cm mark and as i understand it 1 cm (even if it was done all togather) does not pose any danger to nerve or ligament damage. At worst it will just makes you uncomfortable for few days.

Please understand that CLL surgeons are not better than deformity/correction surgeons, they just have more experience delaing with bilateral Cosmetic LL cases. In your case its not bilateral lengthening and its definitely not CLL, in my opinion yours is a straight forward case LL discrepancy correction which can and should be corrected with acute lengthening and than nailing allowing you to get on with your life. This can be done by ANY respectable experienced lower limb deformity correction surgeon even in your home country. Here the key is to look for surgeon who is experienced in lower limb correction surgeries.

This is not a medical advice as i am not qualified to do so and the decision is yours as its your money and legs. Do what you feel most comfortable with.

Good Luck.

I understand you and many thx.

If choosing another doctor is just for saving money but same have same level of expertise I prefer to keep my surgery appointment with Dr Betz in a couple of weeks as i saw him and talked to him for hours and I felt comfortable when I saw his confidentiality in what he is going to do.

None of the real orthopedic surgeons in Europe will take a decision before he sees me and I ll end up spending money and time, unless u believe that real ortho. surgeons can be more professional for my case.

In my country, the problem is no one of the Dr s used telescopic nail before (not available, only external is used and rarely) and they said we can help u and pull it out but better to pull it out with a Dr that is experienced with it because the head of the nail needs special tools to be easily removed same for the screws.

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Quote from: Hamza on September 20, 2019, 12:33:16 PMI understand you and many thx.

If choosing another doctor is just for saving money but same have same level of expertise I prefer to keep my surgery appointment with Dr Betz in a couple of weeks as i saw him and talked to him for hours and I felt comfortable when I saw his confidentiality in what he is going to do.

None of the real orthopedic surgeons in Europe will take a decision before he sees me and I ll end up spending money and time, unless u believe that real ortho. surgeons can be more professional for my case.

In my country, the problem is no one of the Dr s used telescopic nail before (not available, only external is used and rarely) and they said we can help u and pull it out but better to pull it out with a Dr that is experienced with it because the head of the nail needs special tools to be easily removed same for the screws.

You could do a lot worse than going with betz most CLL doctors started as normal lower limb or orthopedic surgeon and betz is an experienced orthopedics surgeon. IMO he is a little greedy and sometimes takes too many risks but that's probably in CLL case. Your case is pretty straight forward corrections case so I don't see any issues with choosing betz. If you can afford him and  money is not an issue than go for it, get it done and move on with your life. You seems like a decent guy so I wish you all the best with surgery!

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Quote from: Infinity on September 20, 2019, 05:15:03 PMYou could do a lot worse than going with betz most CLL doctors started as normal lower limb or orthopedic surgeon and betz is an experienced orthopedics surgeon. IMO he is a little greedy and sometimes takes too many risks but that's probably in CLL case. Your case is pretty straight forward corrections case so I don't see any issues with choosing betz. If you can afford him and  money is not an issue than go for it, get it done and move on with your life. You seems like a decent guy so I wish you all the best with surgery!

Yes I decided to go with him and I ll let u know the result next month.
Attached an xray done today (13 months post sugery).

https://imgur.com/a/gCWJHGL

I feel that i will not need bone grafting, do u agree with me ?
Do u think when we cut the bone again to gain 1 cm the old fracture will break or it looks solid enough ?

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5932753/#!po=2.08333

Not sure how helpful this is, but this is a case similar to yours.

from what I'm gathering, after initial lengthening goals were reached, the nail failed and reversed. Author hinted at weight bearing capabilities of the precise nail being limited as to the reason.

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Quote from: Hamza on September 21, 2019, 09:42:19 AMYes I decided to go with him and I ll let u know the result next month.
Attached an xray done today (13 months post sugery).

https://imgur.com/a/gCWJHGL

I feel that i will not need bone grafting, do u agree with me ?
Do u think when we cut the bone again to gain 1 cm the old fracture will break or it looks solid enough ?

I think you have good consolidation and probably wont be needing any grafting but i think the best person to decide this will be your surgeon. try to listen to him and not impose your opinion as afterwards he will blame you if something will not be right.

It will be wise to re-brake it at the old osteotomy site but again let the surgeon take care of this. he knows the best.

Once again Good luck!

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Quote from: E Z on September 23, 2019, 04:51:13 PMhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5932753/#!po=2.08333

Not sure how helpful this is, but this is a case similar to yours.

from what I'm gathering, after initial lengthening goals were reached, the nail failed and reversed. Author hinted at weight bearing capabilities of the precise nail being limited as to the reason.

Yes when i started walking after 3 months, I was happy with the result.
After that, Dr Allowed me to walk and I started gradually feeling that I need to start adding insoles of 3,5,7... mm s again.