Limb Lengthening Interview with Surgeon - Dr. Franz Birkholtz of IOR in Stellenbosch, South Africa

[@EviAnon]

This man has me sold, if I ever consider doing this surgery it will definitely be with him. Thank you for this interview! Much love! ❤

[@ThembaAndGogo]

I am in South Africa I didn't know there was such locally. Great work Vic with these educational videos. Helps see the market from a larger scale and keeping us informed.

[@janduedalrolfing549]

Dear Franz! Seeing your name popping up, I just had to see the interview. Brutally honest and great explanations. I could not agree more. Stellar performance as always :-) I also completely agree that both lengthening nails are reliable allowing early rehabilitation. For osteolysis safety check out our paper: "Radiographs of 366 removed limb-lengthening nails reveal differences in bone abnormalities between different nail types". I think it is still featured on the homepage of LLRS as research highlight. Looking forward to meeting you again! Best, Jan

[@fbirkholtz]

Hey Jan, Thanks for the kind words and the suggested paper. Interesting read indeed. All the best F

[@mrraam2151]

Dr. Franz is the very first doctor I consulted but he had stopped CLL for a while so I had to cancel the plan but good to see he is back.

[@liam-n8098]

Very informative! Thank you for this!

[@youtubecommentsguy9805]

Have there been autopsies of past lengthening patients? Definitely have to be. Would be interesting to study the inside of the lengthened longbone

[@Cyborg4Life]

Interesting I wonder but yeah I suppose there would be at least a few. Would be a cool discovery

[@Mad-Smith]

Interesting scientific question for aspiring pathologists, orthopaedic physicians or surgeons to do a dissertation about this. Hmmmm someone gotta steal the idea 😅

[@orlandillo21]

I think that for there to be an interesting sample, at least 50 years should pass, in my humble opinion.

[@boblully5053]

Victor is the best

[@MM-sf6fp]

Vic a while back I remember you interviewed a guy that had CLL done at the Paley institute, do have any update about him? I think interview was in summer of last year

[@Cyborg4Life]

I reached out late last year and he said he was doing well. I'm not sure he or any of the others are interested in doing an update. I'll see about reaching out to them eventually

[@MM-sf6fp]

👍🏼👍🏼

[@cuymmer5701]

Interesting interview Victor. Btw, by any case, do you happen to know if there exist les surgeons on latam?

[@taym2720]

Hey Victor, could you do more on Dr Franz? He's based in South Africa and is relatively cheaper, which sounds like a great option for someone like me who was looking to travel to the US from Asia for LL. However, I couldn't really find any diaries of patients who have undergone LL with him which is quite frustrating. Could you suggest something?

[@ameerr.7614]

Vic this is a good 1uestion still relevant even today. To me at least... Please if you know some deiaries I'd be happy

[@قناص-ط8ب]

Welcome I measured and it turned out that the femur is 41 cm and the shin bone is 40 cm What do you recommend for lengthening, is it for the thigh bone or shin bone? What is the safe limit for elongation?

[@قناص-ط8ب]

Please would you tell me What did the doctor say about the safe limit for prolongation? Because I don't speak English I will translate what you say

[@Cyborg4Life]

6.5cm femurs. 4cm tibias but depends on surgeon's decision

[@theinvertedprotagonist]

So $50k for the nailing method, but how much would it be with ex-fix?

[@blkdavid]

I'm pretty new to all of this and I was just looking at the Paley Institute and they have a “2 STRYDE Implants” does anyone know anything about it?

[@youtubecommentsguy9805]

@@avgdude1290 it was initially expected to be back somewhere around in July of 2021 (just a couple of months later than when it was taken back in April 2021)… you see how that went. In reality it probably won‘t be back for quite a long time

[@gj9157]

@@avgdude1290 Same with many other LL websites. They never take it down for some reason.

[@Mad-Smith]

I still think antegrade is superior to retrograde nailing, here’s why. 1) It’s arguable that the damage you do while inserting is much more reversible on the abductor muscle, which you can restrengthen in rehabilitation, or even go as far as have an autograft (transplant from another structure of your body). while there is no good solution for the wearing off of chondrocytes in your joints. There could be one day but until now there isn’t, else we wouldn’t even need knee replacement surgeries and all that when we get osteoarthritis. So imo the knee is more sacred to preserve. 2) when lengthening on an antegrade insertion we lengthen the femur into genu valgum (knock knee) while on the other hand the retrograde situation slowly pushes the mechanical axis into genu varum (bow legs). Arguably bow legs are a worse condition with more pathologies and an aesthetically uglier look than knock knees 3) this might be clinically insignificant but with retrograde lengthening you probably do the bone cut more distal than with the antegrade method. So the more proximal the bone cut is the closer it is to the pelvis and has more blood supply obviously which means a significant faster healing rate. However, not sure if the cut is done really that far below so take this with a grain of salt.

[@Cyborg4Life]

Interesting theories. Perhaps a surgeon will delve into this for proper feedback especially about the lengthening into valgum vs. varum and insertion damage

[@Mad-Smith]

@@Cyborg4Life Sure good question for future videos but keep in mind we are talking about subclinical stuff here, else one method wouldn’t be done at all. It is probably only a significant factor when you have a preexisting axis deviation. For normal patients it is probably the surgeons preference what to prefer and what to do without the methods having any real clinical consequence other each other.

[@loia5tqd001]

Hi Victor, I’m doing the surgery. Currently I’m still in my wheelchair, from which day can I start to learn standing and walking with walker? I’m doing with the LON method. Huge thank to you in advance

[@Cyborg4Life]

Not sure how long you are in your lengthening process but your surgeon should be able to give you an idea of when you are able to start

[@loia5tqd001]

@@Cyborg4Life sure. lol somehow I thought of you even before my surgeon

[@10cmontibia66]

Victor is there something wrong with your site? I can’t access it

[@Cyborg4Life]

Oh you were meaning about the LL Secrets page. Did it not start working after you cleared cache or used different browser. I just checked yesterday and it seemed to be working okay. Have you tried on your phone even? Sometimes PC's or Mac can be finicky

[@DenHenson]

47:50 I love this guy 😂

[@samlaza7697]

Hey victor, I’m 5’4 and my goal is to be at least 5’8 and I plan to do a quad lengthen of 2 inches in the femur and 2 inches in my tibias. I’m 19 and going start college in September 2022, I have a summer break from may 11th to September 16. Would that be enough time for me to recover and be able to at least walk to my classes on campus?

[@MM-sf6fp]

Bro do it!! I was in your situation and didn’t do it while in university and I very much regret it because university is not hard and not as serious as when you are in a job. You can do it if you have some friends that help you with classes for example. Now that I’m working, I’m finding it very hard to find time for this procedure and I regret taking university very seriously in that I won’t be able to manage classes. I was wrong it’s very manageable.

[@samlaza7697]

@@MM-sf6fp thank you! I’ve been very hesitant to doing the procedure since I do know recovery takes a while and I was unsure if 4 months would be enough to be able to start walking again to classes. Guess I’ll have to go through with it this summer!

[@Cyborg4Life]

Hmm probably not for quadrilateral lengthening but perhaps for bilateral femurs of 5cm

[@MM-sf6fp]

Good luck and enjoy

[@DenHenson]

Does stretching help lengthen/prime nerves for lengthening? Is there any way to marginally decrease risk to the nerve pre surgery?

[@Cyborg4Life]

Possibly a bit but probably not as much as you think because they can only acclimate to your current bone length. Once you lengthen they now have to reacclimate and regenerate accordingly.

[@team3gaming749]

Cyborg, after the 3 weeks he mentioned being included in the cost of the surgery, how long do you think a patient should stay after that? If it takes months to lengthen how expensive do you think it could get? Also do they remove the nail free of charge or do you have to pay for that?

[@fbirkholtz]

Hi. Patients ideally should stay till end of distraction which is about three months after surgery. Accommodation in town through airbnb (not always the cheapest) for longer term stays works out to 1000 dollars per MONTH. Food depends very much on preferences and whether you prepare it yourself or not. 25-50 dollars per day would be more than enough for most people. Physio around 50 dollars per session. Three to four sessions per week minimum. Nail removal two years after surgery. Not included. Hope this helps F

[@taym2720]

@@fbirkholtz He isn't in Cape Town. The place where he is seems remote.

[@fbirkholtz]

@@taym2720 I am in Stellenbosch. 30 minutes from Cape Town.

[@team3gaming749]

@@fbirkholtz With all these extra costs would you say an extra 5k is enough?

[@fbirkholtz]

Depending on things like the level of accommodation as well as type of food (precooked vs self cooked vs take aways) it should be enough for most people.

[@MRLDsxn]

Is limb lengthening possible with hernia disci?

[@Mad-Smith]

Hernia disci is not related to that so I don‘t see why it should or should not be a contraindication. Despite what many surgeons tell you though, the younger you are the better for rehab and healing. Yes it can work for 70 year old people as well but it is an arguably much more timely process

[@user-up3tv2ei7g]

Nice

[@gainz6180]

Can i do leg lengthening 6cm femur, 6cm tibia = total 12 cm. Do that one time, then after 5 years after that surgery do another one like that one of 12cm on total again, and then after another 5 years maybe do a one last third one of 12cm. Is it possible? Or its not?

[@Cyborg4Life]

Unless you are diagnosed with a form of dwarfism and your surgeon sees fit, that approach would be nonsensible to follow through with. Talk about having skewed proportions

[@mikemichael5591]

CHUMP

[@Cyborg4Life]

You’re laughable