Yes please Dr Birkholtz tell us do Femurs heal two times faster than Tibias ?
And about this probability of loosing limbs, is it less than 1% or more ?
Thanks in advance.
Dr. Franz, I have a couple and I hope you can answer them.
To start I have to tell that I'm not short, I'm 178~179cm, so if I ever did this surgery would be to reach my dream height of 185cm and to be a little happier with my body, it would not be life changing.
Also, I would prefer to length with the PRECICE 2(less scars, pain).
Okay, now the questions:
I was thinking of lengthening 3cm in the femurs and the 3cm in the tibias, that means 6cm max. Do you think I should length more in the femurs and less in the tibias or would it be irrelevant, in terms of recovery, since we are talking about small amounts of lengthening?
Do you think that I could regain, let's say, at least 90% of my previous athletic ability if I lengthened a max of 6cm?
Last question, imagine that I length my femurs first. Is it possible to do the surgery on the tibias as soon as I stop lengthening the femurs, maybe 2 weeks after? Or is it very risky?
Best regards,
The Plague
Quote from: Machine on December 04, 2013, 08:41:02 PMHey dr franz i have a personal question ?
I recently did 8 cm on my tibia but now i have all this delima that i should have done 6 cm .
I was thinking is it advisable to do limb shortening for just 2 cm ?
If yes then when should i do limb shortening , m already 9 month post surgery.
Is limb shortening a dangerouse surgery ?
What methos is used for limb shortening?
Are there any regular cases of limb shortening?
If i did limb shortening on tibia bone by 2 cm so that i will get back to 6 cm will i get my flexiblity back?
I m not saying i would do it , unless m a millionare, very much curious to know .
Thank you
Limb shortening post CLL is not done often. Whereas the technique is reasonably straight forward, the risk of nonunion would conceivably be high.
If the aim is to regain flexibility, I guess it makes sense to do it sooner rather than later, but it is very difficult to predict how much function will return.
Quote from: Bruno Mars on December 04, 2013, 10:11:38 PMBingo! This is the type of question that I always expect from a good surgeon. Your answer is very bold, yet hold the belief that I always hold on. And I also have another question: Is it true that you can lengthen your femur more than your tibia and expecting a quicker recovery? I have seen this is mentioned many times on most of the CLL surgeons website that I visited. My plan is to do 4.5 cm on tibia and 5.5 on femur. Do you think I can get back to my active sport life if I limit myself to this amount of lengthening?
I think your goals are realistic. Most surgeons would add a bit more to the femur than the tibia. Healing times are a little bit quicker on the femur, but not really to large extent. If you do not exceed 10cm, your chances of returning to sport are higher.
Quote from: Claude on December 04, 2013, 10:45:10 PMYes please Dr Birkholtz tell us do Femurs heal two times faster than Tibias ?
And about this probability of loosing limbs, is it less than 1% or more ?
Thanks in advance.
Unfortunately healing times are only slightly quicker on femurs.
Amputation rates post CLL not known. If you have a good surgeon this should be zero or very close to zero.
Quote from: ThePlague on December 04, 2013, 11:48:45 PMDr. Franz, I have a couple and I hope you can answer them.
To start I have to tell that I'm not short, I'm 178~179cm, so if I ever did this surgery would be to reach my dream height of 185cm and to be a little happier with my body, it would not be life changing.
Also, I would prefer to length with the PRECICE 2(less scars, pain).
Okay, now the questions:
I was thinking of lengthening 3cm in the femurs and the 3cm in the tibias, that means 6cm max. Do you think I should length more in the femurs and less in the tibias or would it be irrelevant, in terms of recovery, since we are talking about small amounts of lengthening?
Do you think that I could regain, let's say, at least 90% of my previous athletic ability if I lengthened a max of 6cm?
Last question, imagine that I length my femurs first. Is it possible to do the surgery on the tibias as soon as I stop lengthening the femurs, maybe 2 weeks after? Or is it very risky?
Best regards,
The Plague
Thanks for your questions. Lets get to them first. Small distances are safer, but end up being very expensive per cm! If youre really only looking for 3 each segment, one could shorten the times between top and bottom, but not before consolidation and full knee movement.
You may not like what I will tell you next, but as a doctor I have to.
Please think carefully about CLL. I do not think you are a candidate. The reason I say this is in your first paragraph where you state CLL will not be life changing. If it is not life changing, the potential risks are too high. In addition you are already at more than the target height most CLL patients dream of. Make up those 2-3 inches in personality and you will be much happier than with a CLL which may compromise your function for life...
My apologies if my response makes you angry! 
When did you first develop an interest in orthopedics? What aspect of being an orthopedic surgeon do you like most?
Quote from: Kilokahn on December 06, 2013, 12:21:11 AMWhen did you first develop an interest in orthopedics? What aspect of being an orthopedic surgeon do you like most?
[/quote
As soon as I came across it in med school.
Repairing broken people.
Quote from: Franz on December 06, 2013, 12:01:17 AMI think your goals are realistic. Most surgeons would add a bit more to the femur than the tibia. Healing times are a little bit quicker on the femur, but not really to large extent. If you do not exceed 10cm, your chances of returning to sport are higher.
Thank you for your answer dear sir. You sound like a good surgeon with a good heart, not like others who try to satisfy patients and let them lengthen insane amounts on their legs. Even though I have set my mind that no matter what would the doctor say I will go for max 5 cm per limb. And you just assured me that I have made a good decision.
To LL Forum: I think Dr Franz is a very interesting new option guys. Too bad that I don't have enough money to go with him next year. I have planned everything, I can only gather 20k for my surgery in India. I would be very interesting to see a new diary in S.Africa. I will probably go there for my femur surgery in 2,3 years though.
When I sent an inquiry to another orthopedic surgeon about the use of PRECICE I was sent a word file talking about the advancements in cosmetic lengthening. Within it there was a section that addressed fibular complications.
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Fibular complications: With tibial lengthening the fibula has to be lengthened too. The implantable lengthening device only lengthens and fixes the tibia. The fibula has to be fixed to the tibia so that it lengthens together with it. If the fibula is not fixed or not fixed adequately it will not lengthen as much as the tibia and will lead to severe consequences including subluxation and arthritis of the ankle and flexion contracture of the knee. The method of fixation is critical. Many surgeons only fix the lower end of the fibula to the tibia. This can lead the fibula to prematurely consolidate and to pull down and dislocate from the tibia at its upper end. It is important to fix the fibula at both ends. With external fixation the fibula can be fixed with the wires of an external fixator. With implantable lengthening the fibula must be fixed with screws to the tibia; one screw at the upper end and one at the lower end. The angle, level, position, diameter, and type of screw are all important. E.g. a common mistake is to put the screw in horizontally between the two bones. This is not strong enough to prevent the fibula from pulling away from the tibia at the ankle. This is very subtle and even a few millimeters of difference in length of the fibula at the ankle lead to short term and/or long term consequences for the patient.
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I've seen many x-rays from other surgeons where the fibula is cut but it's not fixed to the tibia. There was an ongoing debate on that other site a while ago about how important fibula fixation really is. What is your opinion on the importance of the method of fixation of the fibula?
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