Dr Franz Birkholtz (Pretoria, South Africa)

Edit Post

Alright. alright. alright.
Me too, I wanna be your patient one day.

Quote from: Blackhawk on March 06, 2014, 08:37:50 PMThanks for your participation here Dr. B.

I hope to be one of your fake patients one day. 

Edit Post

Dr Franz is the best thing that has ever happened to this forum. The information he posts here and his interaction with prospective LLers is pure gold.

It's because of him that I've changed my own personal goals into something more realistic, learned a lot about methods and became much more aware of our body limits and the seriousness of this procedure.

I don't think I'd be accepted as one of his patients though as I'm 173cm (which is over his 165cm limit but nevertheless short here in Europe), but if I had the time right now and he accepted me, he'd definitely be my choice.

I'm not questioning every other doctors' integrity, but there seems to be a lot of mercenaries in this business, operating in countries that will not provide you with any protection if anything goes wrong.

Edit Post

Also do patients have a choice of spinal anesthetic or is it only general available?

Thanks again Dr B

Edit Post

Hi guys,

Again thanks for the kind words and support.

My limits are less than other doctors allow, because of safety. I will inevitably have less patients interested, but I am happy, since their outcomes should be good. These limits are however arbitrary and may change somewhat it individuals. I do not want to promise 8cm on a femur and then we achieve only 4 because of knee contractures etc.

The cutoff of 165 is a general rule. There may be exceptional circumstances where this rule can be relaxed. This is best discussed on a one-to-one basis.

Anaesthesia is offered by a very experienced group and they offer different options like general anaesthesia with nerve blocks, GA with patient controlled analgesia, spinal, or combinations. This is individualized per patient. Safety is always the primary concern and awareness has not been an issue at all.

Edit Post

Dr. Birkholtz,

Should a length gained in the tibia by an Ilizarov apparatus correspond to the actual gain in height, or is it similar to the internal nail's mechanism? Thanks.

Edit Post

dr franz,

thank you for all your valuable info,

I just want to do one surgery and want to gain 8 or 9 on my femurs and be done with LL, are you saying that the larger femur:tibia ratio will eventually cause arthritis or the malalignment?

so if i go all the way to 8cm with precice 2 on my femurs i will eventally get knee pain or arthritis? I am not worried about contracture because if I go with paley he will prob do itb and fb release.

thank you for all your info!!

Edit Post

hello doctor Frank,
what method do you prefer for lengthening 5,5 cm in tibias? LON or LATN.

Edit Post

Quote from: Franz on March 12, 2014, 06:59:16 PMThe downside of long lengthenings along the anatomic axis (like with precice, guichet, betzbone, iskd), is that we change the mechanical alignment of the femur, as we lengthen along a different axis. This means that intramedullary lengthenings in the femur beyond 5-6cm will inevitably lead to slight malalignment. This may in time lead to arthritis.
In short, keep to reasonable distances and go to a doc that understands this.

Dr. Birkholtz-  Why would lengthening 5-6cm be any safer than 6.1-8cm in terms of only malalignment? If lengthening along the anatomic axis with internal nails causes malalignment, since you're not lengthening along the mechanical axis, wouldn't any amount of lengthening then cause malalignment? What is it about lengthening 5-6cm and malalignment that makes it any safer than 6.1-8cm if all internal lengthening causes malalignment?

Thanks for all your information.

Edit Post

Think I might answer my own question. Read online that in the tibia these axes are coincidental, so I assume height achieved is equal to height distracted.

Edit Post

Quote from: handy on March 12, 2014, 08:44:06 PMDr. Birkholtz-  Why would lengthening 5-6cm be any safer than 6.1-8cm in terms of only malalignment? If lengthening along the anatomic axis with internal nails causes malalignment, since you're not lengthening along the mechanical axis, wouldn't any amount of lengthening then cause malalignment? What is it about lengthening 5-6cm and malalignment that makes it any safer than 6.1-8cm if all internal lengthening causes malalignment?

Thanks for all your information.

I have the same question specifically about malalignment.