Dr Franz Birkholtz - CLL in Stellenbosch, South Africa

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Hi,

Unilateral lengthening, as in planned bilateral, but staged so that one leg is done at a time?

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Quote from: Franz on May 09, 2023, 07:48:05 PMHi,

Unilateral lengthening, as in planned bilateral, but staged so that one leg is done at a time?

Hi Dr. Franz,

do you think unilateral staged lengthening is the safest way to do a cosmetic leg lengthening?

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Quote from: Limbfan2020 on May 09, 2023, 07:58:32 PMHi Dr. Franz,

do you think unilateral staged lengthening is the safest way to do a cosmetic leg lengthening?

An interesting question.

It is certainly a smaller procedure than bilateral surgery per setting, but of course it has to be performed twice. That probably pushes the safety statistics back to roughly the same level.

I am not fond of doing this. It induces a significant (6-8cm) leg length discrepancy for the time bewteen the two procedures. That makes real weight bearing quite difficult. And more importantly, if, for some reason the second procedure doesn't get done (logistics, pandemics, wars etc), the patient is left with the significant LLD and would suffer from a significant functional impairment.

Hope it makes sense.

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Dr Franz what would you say is currently the main thing holding back LL patients in terms of athletic ability in the long run?
Is it things like the ITB and Achilles Tendon that don’t respond that well to lengthening or is it a general weakening of the muscles from the lengthening?

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I read that Dr Franz allows Precise 2.2 patients to weight bear as much as they can handle, is this true?

Wouldn't it break the nail?

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Quote from: Franz on May 08, 2023, 06:18:15 PMIt 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.

Do you make the decision to go retrograde or Antegrade with the patient before surgery or see what works best once you get cutting?

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Quote from: TheDream on May 09, 2023, 08:28:49 PMDr Franz what would you say is currently the main thing holding back LL patients in terms of athletic ability in the long run?
Is it things like the ITB and Achilles Tendon that don’t respond that well to lengthening or is it a general weakening of the muscles from the lengthening?

It is probably all of the above to different degrees in different patients. It is definitely true that shorter lengthenings recover better.

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Quote from: 1team on May 09, 2023, 11:12:02 PMI read that Dr Franz allows Precise 2.2 patients to weight bear as much as they can handle, is this true?

Wouldn't it break the nail?

Precice nail is limited to 35kg. Fitbone limited to 20kg during lengthening and up to 100kg thereafter.

I allow safe progression to weight bearing in a graduated way depending on bone growth etc

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Quote from: 1team on May 10, 2023, 09:03:14 AMDo you make the decision to go retrograde or Antegrade with the patient before surgery or see what works best once you get cutting?

A detailed plan is made with the patient prior to surgery and we discuss this weeks in advance, usually during a zoom call.

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Jello dr. Franz. A well known surgeon in my country says he prefers to do bilateral femurs but with a 2 weeks distance between each leg in order to minimize risk for PE or fat emboli. What is your take on this approach?