General information and response from Dr Maurizio A. Catagni, of Mangioni Hospital, located in Lecco, Italy.
Note: Previous Discussion Thread Linked Here
http://www.limblengtheningforum.com/index.php?topic=783.0BackgroundProfessor at the Milano University, Medical School
Former Chief of Orthopaedic department and the Ilizarov Unit "Alessandro Manzoni " Hospital - Lecco
Director of the Ilizarov Unit at Mangioni Hospital - Lecco
Cosmetic lengthening procedure:I use the external fixation or internal with Precise for leg lengthening 7-8 cm
With ex fix you can walk immediately, with the nail you can not walk for 5 month (risk of nail breakage)
Usually I do the surgery, and, after 3 days you can go home (if you live in Europe)
After 30 days I need x-rays (may be you take home and send me via e-mail) After other 15 days I need to see you clinically with new x-rays, followed by check every 3-4 week in Lecco until the lengthening is achieved (usually 4 months)
During the period of lengthening (after 3-4 cm) probably you need Achilles tendon lengthening, and you have to stay at the hospital for other 3 days. The cost of the procedure is included in the fee.
Ilizarov frame for leg lengthening:At the level of the leg, with 2 level of osteotomy in the tibia and one level osteotomy in the fibula, for an amount of 5-8 cm, depending from the patient.
The rate of lengthening is 1⁄4 mm 2 or 3 time a day every level (depending from the age and the biology of the patient); in total is 1 or 1.5 mm per day
The time for treatment is:
- 70-90 days for lengthening with simultaneous Physiotherapy; walking with crutches.
- 4-5 months for bone consolidation walking with crutches but full loading .
- Frame removal and brace or plaster for 2 months: free walking.
- Total time of treatment in the frame: approximately 8-10 months
CostIn terms of cost, the ex fix lengthening cost about 22.000 euro, the [Precice] nail is 50.000
AccommodationIn Lecco it is possible to rent a flat at the cost of 1000€ per months where the patient have to stay (3-4 months) with a person helping him in the day life (such person have to be or a relative or friend of the patient). For local nurse the fee is about 800€ a month. Is available, some time, a 3 room apartment at a cost of 1000€ per month
Possible complications- Achilles tendon lengthening (70% of the patients), after 3-5 cm of lengthening
- Superficial wire infection treated with local or oral antibiotics
- Delay of new bone formation (10% of the patients), with more time in the frame
- Deformity treated with progressive frame modification (no surgery or painful maneuvers)
- Neurovascular damages: never happen in cosmetic
Most common questions1) How long would it take before I am able to participate in day-to-day activities, like walking, doing office work, etc. (no sport)?
- After few days you can walk with crutches without the possibility to drive a car and just for moving inside the house; of course, if you work sitting, you can do it. For a comfortable walking you have to wait 4 months from the operation
2) How long would I have to stay in your hospital?
-You have to stay in the hospital for 3-4 days
3) How much does the operation approx. cost (incl. hospital stay, necessary checks, therapies, etc.)?
-The fee for the hospital and operation is 20.000 € the cost of the therapy is about 800 US$ per month (3 months in Lecco); after you can go back home and send me X-rays via Internet Until the frame removal (you can do it in your Country) It is possible to rent a flat in Lecco for about 1000 € per month but you need somebody living with you during such period to help in the daily living; For achilles tendon lengthening 5000 € extra fee
4) Are the incisions of the pins or cuts visible later on and can they be removed, e.g. by laser (and do you know who is offering it at what cost)?
- The scars are minimal and few of my patient ask for such operation
5) As a patient, I have to trust your opinion and expertise. While some doctors are against leg-lengthening for cosmetic reasons, I personally believe this is up to the patient and the performing doctor to decide if the procedure is safe and secure enough to be recommended for cosmetic reasons.
- I don’t suggest to do the tibial lengthening if you are normal except if you have serious psychological problems
6) I feel very short and I believe I could enhance the quality of life by pursuing a leg-lengthening operation. However, I also believe I will be able to survive without doing it. You have done many operations and you know how patients feel afterwards. Reflecting on your experience, would you recommend this operation for cosmetic reasons?
- Following my experience, all the patients after lengthening are happy because they forget quickly the difficulties suffered during the treatment.
Contact Info:Maurizio A. Catagni, M.D.
Office: Lecco – 42/H, Via C. Cattaneo, 23900
Tel. +39-0341-364662
Rome - 567 viale dei Colli Portuensi
Tel. +39-06-6570951
Fax: +39-0341-630630
E-mail: maurizio@catagni.it