Dr Franz Birkholtz - CLL in Stellenbosch, South Africa

Edit Post

Good luck! Awesome to hear that someone is doing this with Dr. Franz

Are you going to create a diary for your LL journey?

Edit Post

Dr Franz, do you still use ilizarov fro cosmetic becuase of cost some of us cant afford internal?

Edit Post

With second-hand TSF frame, it's 30k. If new, no idea.

By the way, we don't do external just because it's cheaper. There are a lot of advantages.

Edit Post

Quote from: 1team on April 19, 2023, 08:48:11 AMDoes Dr Birkholtz do retrograde or Antegrade femurs? I read on his old thread where he said that passing 6cm Antegrade will increase joint pressure and risk of osteopetrosis later in life.

But obviously doing retrograde can fk with your knees.

He said in an interview with Victor from cyborg4life on youtube that he can do antegrade or retrograde regardless of the nail used, but that’s a decision the surgeon makes depending on the situation.

Edit Post

Quote from: Vogel on April 19, 2023, 12:01:51 PMGood luck! Awesome to hear that someone is doing this with Dr. Franz

Are you going to create a diary for your LL journey?

Thank you man. I Sure will!

Edit Post

Quote from: 1team on April 19, 2023, 08:48:11 AMDoes Dr Birkholtz do retrograde or Antegrade femurs? I read on his old thread where he said that passing 6cm Antegrade will increase joint pressure and risk of osteopetrosis later in life.

But obviously doing retrograde can fk with your knees.

It is a very individual decision, depending on many individual factors for every patient. Generally around 80% of our CLL patients end up with antegrade femoral lengthening using a nail.

Edit Post

Quote from: Thehighest on April 19, 2023, 04:59:11 PMDr Franz, do you still use ilizarov fro cosmetic becuase of cost some of us cant afford internal?

I am very comfortable using external devices for lengthening and use the hexapod fixators like the TLHex and TSF as a rule.
We will not consider CLL for femurs using external fixation.

The biggest drawback of external fixators is the time in frame. It is 1.5-2 months for every cm lengthened. That means that a 4cm tibial lengthening needs the frames on for 6-8 months.

Edit Post

Quote from: Franz on May 08, 2023, 06:21:35 PMI am very comfortable using external devices for lengthening and use the hexapod fixators like the TLHex and TSF as a rule.
We will not consider CLL for femurs using external fixation.

The biggest drawback of external fixators is the time in frame. It is 1.5-2 months for every cm lengthened. That means that a 4cm tibial lengthening needs the frames on for 6-8 months.

Do you allow patients to lengthen 8cm in femur with Precice?

Edit Post

Officially I encourage a safe limit of 6.5cm on the femurs.
We do find that a lot of patients reach that point and the soft tissues and nerves allow more. Then we do sometimes go to the maximum of the nail, which is 8cm.

My strong recommendation would be to aim for 6.5 as a minimum goal and see how it goes when you get there.

Edit Post

Quote from: Franz on May 09, 2023, 07:39:53 PMOfficially I encourage a safe limit of 6.5cm on the femurs.
We do find that a lot of patients reach that point and the soft tissues and nerves allow more. Then we do sometimes go to the maximum of the nail, which is 8cm.

My strong recommendation would be to aim for 6.5 as a minimum goal and see how it goes when you get there.


Do you do unilateral lengthening doc?

What’s your recommendation for someone that wants to weight bear right after the surgery?