Q & A With Dr Franz Birkholtz

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Quote from: Taller on December 15, 2015, 03:54:09 PMWould you be willing to perform plating and frame removal for patients who got their frames installed and lengthening done with another doctor?

Obviously I would prefer to do this in planned cases where I performed the first surgery. Having said that, I am always available to help patients with problems, including complications or a change in plans. This is a sensitive area, since I can only take over a patient's care if they request it. The first surgeon is usually the best person to continue the treatment.

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Do you think femur leng. with Lon is safe ?

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Hi Dr. Franz,

with regards to the rubber band analogy, is there really such a thing as a "safe limit"?

I understand that if a rubber band is stretched *beyond a point*, it loses its strength and elasticity permanently. But even if a rubber band is *slightly* stretched and held for hours together, it would still lose strength and elasticity. Does this analogy hold 1:1 with soft tissues, muscles and nerves?

Thank you

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Dr. Birkholtz,
Perhaps this is an odd question. How much wheight would be gained after lengthening 5cm´s on the femurs compared to the same amount on the tibias? It obviously depends on the individual and the size of the bones but I´d like to know how much more wheight would be gained on the femurs. The idea of being light for the height you get after lengthening the tibias displeases me a lot and is one of the reasons why I lean towards a femur lengthening. Thanks in advance for your reply!
Regards,

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Quote from: Revenge on December 26, 2015, 06:51:27 AMDo you think femur leng. with Lon is safe ?

Good question, but not easy to answer. AS with any surgery it is as safe as the surgeon you choose.

It is technically quite difficult and has a risk of infection, so we tend to shy away from it.

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Quote from: SAD on December 26, 2015, 07:40:38 AMHi Dr. Franz,

with regards to the rubber band analogy, is there really such a thing as a "safe limit"?

I understand that if a rubber band is stretched *beyond a point*, it loses its strength and elasticity permanently. But even if a rubber band is *slightly* stretched and held for hours together, it would still lose strength and elasticity. Does this analogy hold 1:1 with soft tissues, muscles and nerves?

Thank you

You are right. There is no absolute safe limit, but from our experience in managing thousands of cases of deformity, congenital conditions, bone defects etc, the least complications happen below the 5.5cm mark.

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Quote from: Alittletooshort on January 12, 2016, 09:44:52 PMDr. Birkholtz,
Perhaps this is an odd question. How much wheight would be gained after lengthening 5cm´s on the femurs compared to the same amount on the tibias? It obviously depends on the individual and the size of the bones but I´d like to know how much more wheight would be gained on the femurs. The idea of being light for the height you get after lengthening the tibias displeases me a lot and is one of the reasons why I lean towards a femur lengthening. Thanks in advance for your reply!
Regards,

Hi, good question. I don't have a scientific answer for you, but the weight gain between femoral or tibial lengthening should be very similar.

There is probably more weight gain with the lack of sports and BicMacs because of boredom during lengthening! ;-)

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Hello dr.

  I would like to know, from your past experience, what was the safest upper limit of internal femural lengthening in centimeters that you have wintnessed? I mean how many long term complications did you encountere?

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Quote from: TIBIKE200 on January 19, 2016, 03:12:57 PMHello dr.

  I would like to know, from your past experience, what was the safest upper limit of internal femural lengthening in centimeters that you have wintnessed? I mean how many long term complications did you encountere?

He has already made it clear that 5-6cm for Femurs is the safest limit in his eyes.

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Hi Dr Birkholtz

I want to know what you think about pre-op preparation.

How important is flexibility?

I've heard conflicting things about leg muscle/ strength.

Some say strong muscular legs are good and others say they are bad and suggest reducing muscle mass before the procedure. What is your view on this?

What would be optimal?

Would strong and flexible legs like that of a martial artist or gymnast be ideal?

Thank You