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[ForcedPuberty]

that's not true,your not confined to a wheelchair after surgery normally. 1 leg at a time seems ridiculous.

at the very least you should do the second leg 2 weeks after the first leg.

[Leonardo2013]

Hey Musicmaker,

I asked him about Precise, too, and he told me he's trained on it but that he still prefers Fitbone. I asked him other questions (in Spanish) such as what would happen if the Fitbone nail would malfunction and I needed a replacement. He told me that this is rarely to happen but if it were to happen, then the manufacturer Wittenstein would replace it for free and he would not charge anything extra. Then I asked him the material of the Fitbone he uses. He mentions that he prefers no to use Titanium because of "cold fusion" and "deformation" of the nail that could later on difficult its removal. He said his Fitbone nails are approved by the CE and the FDA. And I also asked him about physical therapy. He said that it is included in his price -- 18k Euros per leg -- for the time you are at the hospital. Then he said that it could be done at your home/hotel for 20 - 40 Euros per session or he could refer you to a PT Center in Barcelona. Finally, he recommends operating one leg and staying close by for 1 month and then going home to continue the lengthening there. I hope this helps.

His presentation of the use of Fitbone on his patients looks very convincing to me: http://www.mediafire.com/view/he6f42q1r3fqfa9/Presentaci%C3%B3n_Fitbone.pdf I wish I could take a vacation to Barcelona and pay him a visit.

[TomD]

that's not true,your not confined to a wheelchair after surgery normally. 1 leg at a time seems ridiculous.

at the very least you should do the second leg 2 weeks after the first leg.

I am not one to take concepts lightly nor act on impulse on something as drastic as this. However, after much thought, for those of us who intend to do all 4 bones should definitely consider one leg at a time .

I have never been a fan of doing either tibias or femurs only. Our bodies are designed to specifications for a reason. Lengthening one segment of a bone without the other throws our entire genetic training out of whack. For hundreds of thousands of years we have had femur / tibia relationships that allows movement in all kinds of ways we take for granted.

For those of us who have maladies that make the relationship uneven, then certainly lengthening the shortened bone to fit is good medical practice.

For us seeking cosmetic surgery with normal tibias and femurs, we need to lengthen both bones the same amount.

I would far rather wear lifts and use crutches to move around during the lengthening period rather than be stuck in a wheelchair because both legs are damaged. The more I have thought about it the more it made sense.

Yes, it means a 2 year commitment. However you have reasonable mobility during the entire two years.

[KiloKAHN]

Seems like a whole lot of time wasted if you ask me.

[ReadRothbard]

Damn straight.

[TomD]

Seems like a whole lot of time wasted if you ask me.

Correct me if I am wrong , but isnt the timeline for doing 1 tibia 1 femur at the same time then 10months to a year later do the other leg the same as doing tibias one time then a year later doing femurs?

[Leo]

2 years, are you sure?

According to Monegal: to lengthen 6cm will take about 3 months. So if you do "stage 1" that could take approx. 8 months when you consider full consolidation for all 4 bones. I think he wrote earlier to wait about 4-6 weeks to enter the 2nd surgery. By the time you lengthen the other bones your first tibia and femurs will have fully consolidated. So the way I look at it maximum 1 year.

He also mentioned that Fitbone will release a new version by 2017 or 18. One can only hope this new version will improve recovery time and make it more painless.

Maybe Monegal can confirm this.

Leo
 

[GeTs]

2 years, are you sure?

According to Monegal: to lengthen 6cm will take about 3 months. So if you do "stage 1" that could take approx. 8 months when you consider full consolidation for all 4 bones. I think he wrote earlier to wait about 4-6 weeks to enter the 2nd surgery. By the time you lengthen the other bones your first tibia and femurs will have fully consolidated. So the way I look at it maximum 1 year.

He also mentioned that Fitbone will release a new version by 2017 or 18. One can only hope this new version will improve recovery time and make it more painless.

Maybe Monegal can confirm this.

Leo
 

How can a mail improve recovery time of Your organism?

[Leonardo2013]

Well, he told me he would start on the second leg 4 months after the first one. So, to put it in simple words, you go to Barcelona and have surgery for one leg, stay there for 1 month, then go back home to continue lengthening, then 4 months later when you finish lengthening and are consolidating you come back to Spain to start the second leg and after 1 month go back home again, and 1.5 years later obviously you go back to have him remove the nails free of charge except for the hospital stay fees. He mentions that his rational for going home after just one month is that he wants his patients to continue his normal activities back home. however, he told me that he could help arrange for lodging in Barcelona if the patient requires it. In my personal opinion going back home early can save you money. I hope this helps. 

[galaxy1]

Hey Musicmaker,

I asked him about Precise, too, and he told me he's trained on it but that he still prefers Fitbone. I asked him other questions (in Spanish) such as what would happen if the Fitbone nail would malfunction and I needed a replacement. He told me that this is rarely to happen but if it were to happen, then the manufacturer Wittenstein would replace it for free and he would not charge anything extra. Then I asked him the material of the Fitbone he uses. He mentions that he prefers no to use Titanium because of "cold fusion" and "deformation" of the nail that could later on difficult its removal. He said his Fitbone nails are approved by the CE and the FDA. And I also asked him about physical therapy. He said that it is included in his price -- 18k Euros per leg -- for the time you are at the hospital. Then he said that it could be done at your home/hotel for 20 - 40 Euros per session or he could refer you to a PT Center in Barcelona. Finally, he recommends operating one leg and staying close by for 1 month and then going home to continue the lengthening there. I hope this helps.

His presentation of the use of Fitbone on his patients looks very convincing to me: http://www.mediafire.com/view/he6f42q1r3fqfa9/Presentaci%C3%B3n_Fitbone.pdf I wish I could take a vacation to Barcelona and pay him a visit.

Leonard, are you sure 18k euro is for entire leg, 1 tibia + 1 femur, also known as unilateral?  Incredible price if correct.

[TomD]

I think the whole deal for 4 bones is 66,000 Euros I read on the other page.

I really like the idea that its only 4 months after consolidation begins that we can do the other leg. That really cuts down on the time.

I wonder if he would offer a discount if you paid for all of it upfront.

[Dr Monegal]

No no. Patients pay fist operation and second one when second leg is operated.

[Dr Monegal]

Hello. It all comes up to your proportions between tibia and femur. It is very important ends up with cosmetic and biomechanical good outcome.
Reasons to perform first one leg and then the second while using intramedullary are many. You can ask others like Baumgart or Christensen and they will give you same reasons.
First of all is to avoid fat embolism due to Long bone reaming. Second is you can go back no a quite normal life quite straight away. Performing both legs would confine you to a wheelchair while lenthenning and consolidating.
It s not a matter of being afraid, It is that I will never put life of my patients under vital risk.
Other doctors can do whatever they want. I am aware that some patients do not like the idea at first...but they change the ir minds 2 week after surgery when they can go back to theur offices.
Our protocol might be different, but do believe me It s much safer.
My duty is to inform you and that s why I am here. You guys do a great Job sharing experiences and opinions. So please keep doing It and I will be more than happy to help you all on whatever question that may arise.

[TomD]

Ok Doc but just to make one thing clear:

We can do 1 tibia and 1femur on the same leg at the SAME time. Then wait to do the other leg.

1) How long do we wait to do the other leg?

2) How much does each leg cost (1 femur 1 tibia) ? Is it the 32,000 euro?

Thank you.

[JP]

Hi Dr. Monegal:

Do the fitbone nails come in different sizes?  What is the smallest size you have?


After I finish my lengthening (6cm) with internal femur my knee axis will be shifter out of place will this cause arthritis?
 I would like to hear what you think about this:
 " The effect on mechanical axis deviation of femoral lengthening with an intramedullary telescopic nail. "
 http://www.ncbi.nlm.nih.gov/pubmed/22933497

[JP]

Thanks, Dr. Monegal

[TomD]

His presentation of the use of Fitbone on his patients looks very convincing to me: http://www.mediafire.com/view/he6f42q1r3fqfa9/Presentaci%C3%B3n_Fitbone.pdf I wish I could take a vacation to Barcelona and pay him a visit.

I viewed the presentation. Thanks Leonardo ! 

[JP]

Hello Dr. Monegal;

What I meant to say earlier was that the femurs will have malalignment because of internal lengthening, according to the article;

" The effect on mechanical axis deviation of femoral lengthening with an intramedullary telescopic nail. "
 http://www.ncbi.nlm.nih.gov/pubmed/22933497

so is a little malalignment (6mm) enough to cause arthritis ?

[ForcedPuberty]

it will cause uneven wearing to do 1 leg at a time.

I have no clue on earth why people are trying to jump on this bandwagon. from a scientific point of view this method sux.

the only advantage is you are safer from fat embolism. that is it.

everything else about doing 1 leg at a time is crazy.

[ForcedPuberty]

first off please stop going off like a broken record on fat embolism, I already said it was the only advantage, even if its probability is over exaggerated,

second please stop saying you are confined to a wheelchair and this method means no wheelchair, there are many internals from different doctors which will not leave you confined to  wheelchair. so this point is mute.

lengthening 1 leg at a time will cause uneven wearing, its is ridiculous to even question this. I wont bother explaining why.

lengthening 1 leg at a time means you will be crippled for much longer, all because of the "scary" fat embolism.

and after you operate on the second leg if it is within a 6 month period of the first surgery, I highly doubt you will be walking any distances other than short distance,  which means you will need a wheelchair. a wheelchair is not for people who can not walk, it is for people who can not walk large distances.

[Leo]

Ok Doc but just to make one thing clear:

We can do 1 tibia and 1femur on the same leg at the SAME time. Then wait to do the other leg.

1) How long do we wait to do the other leg?

2) How much does each leg cost (1 femur 1 tibia) ? Is it the 32,000 euro?
That was the price he listed, so it should be correct.

Thank you.

1) I believe, from what I understood, you do 6cm on tibia and femur. That will take approx. 3 months. After the 4th month you do the second surgery. Because you consolidate for one month before you enter the 2nd surgery.

2) That was the price he listed, so it should be correct.

Leo

[TomD]

first off please stop going off like a broken record on fat embolism, I already said it was the only advantage, even if its probability is over exaggerated,

second please stop saying you are confined to a wheelchair and this method means no wheelchair, there are many internals from different doctors which will not leave you confined to  wheelchair. so this point is mute.

lengthening 1 leg at a time will cause uneven wearing, its is ridiculous to even question this. I wont bother explaining why.

lengthening 1 leg at a time means you will be crippled for much longer, all because of the "scary" fat embolism.

and after you operate on the second leg if it is within a 6 month period of the first surgery, I highly doubt you will be walking any distances other than short distance,  which means you will need a wheelchair. a wheelchair is not for people who can not walk, it is for people who can not walk large distances.

You havent explained your point of view.  You are doing the surgery on 1 leg so there is no stress on the other leg . You wear increasing lifts on your healthy leg to match what you are growing on the other. Its not rocket science.

Doing bi lateral surgery puts 'uneven wear' on either the tibias or femurs . The bone that isnt being operated on will get 'uneven' wear instead of one tibia and one femur.

I have known many folks growing up who broke their leg and its far different from someone who broke both legs. The difference in mobility is night and day.

I would prefer to be able to walk around the entire time I am doing both surgeries. This would allow that.

[TomD]

1) I believe, from what I understood, you do 6cm on tibia and femur. That will take approx. 3 months. After the 4th month you do the second surgery. Because you consolidate for one month before you enter the 2nd surgery.

2) That was the price he listed, so it should be correct.

Leo

So it means 6cm EACH right? I would prefer 7 each so i suppose I can talk him into it if I have no complications by 6cm.

I have written him via email and asked him a question about pricing on here but still no reply. The main thing is the guy doesnt honestly expect us to do FOUR surgeries.

One tibia, then wait. Then come back for second tibia, then wait, then come back a year later one femur then wait then come back for another femur.

That is why I want clarification for the record that it be 1 femur 1 tibia one leg at the same time. Otherwise its not worth it.

[Leo]

So it means 6cm EACH right? I would prefer 7 each so i suppose I can talk him into it if I have no complications by 6cm.

I have written him via email and asked him a question about pricing on here but still no reply. The main thing is the guy doesnt honestly expect us to do FOUR surgeries.

One tibia, then wait. Then come back for second tibia, then wait, then come back a year later one femur then wait then come back for another femur.

That is why I want clarification for the record that it be 1 femur 1 tibia one leg at the same time. Otherwise its not worth it.

The best option would be to visit him..

[ForcedPuberty]

doing tibia and femur on 1 leg at the same time is a bad idea. you will loose your range of motion like you have no idea.

this is such a fad. weak minds will fall for shinny ideas.

[TomD]

doing tibia and femur on 1 leg at the same time is a bad idea. you will loose your range of motion like you have no idea.

this is such a fad. weak minds will fall for shinny ideas.

You keep saying this but you don't say how you know that. 

Lose your range of motion? How?

I think it makes common sense. However, I am not a doctor so we will see what he says . This is a very rare question. Most of the time the question is posed as doing both sets at the same time. As in all 4 bones.

I went and had a gander at old forum  and the issue gets brought up but then is always all 4 bones at the same time which would be too much for your body to bear.

If you can do 2 tibias or 2 femurs, it stands to reason your body can handle 1 tibia and 1 femur.

Lets see what the doctor has to say. If anyone else can point us to medical abstracts regarding ONE tibia and ONE femur, I would also like to take a look at them.

[TomD]

The best option would be to visit him..

Hi Leo.

I feel that a question this basic can and should be given to potential patients of his on this thread.

Either he is willing to lengthen one tibia and one femur at the same time or not.

If he wants us to do 4 separate surgeries to get the job done then it is in fact a waste of time. There is no need for it.

[Leo]

Hi Leo.

I feel that a question this basic can and should be given to potential patients of his on this thread.

Either he is willing to lengthen one tibia and one femur at the same time or not.

If he wants us to do 4 separate surgeries to get the job done then it is in fact a waste of time. There is no need for it.

Hello TomB

He starts with one leg by doing tibia and femur in one surgery, and then you do the other leg. He calls it stage 2.
Stage 1 is when you do all 4 bones at the same time in one surgery.

Hope this helps

Leo

[ForcedPuberty]

so let me get this right.

he does not do 2 tibias at the same time because hes scared of fat embolism.

he does not do 2 femurs at the same time because he is scared of fat embolism.

but he does both tibia and femur in the 1 operation because fat embolism magically disappears when its the same leg................

I smell bull  .

[KiloKAHN]

I asked Dr Parihar's assistant Dr Ahuja (or Dr Divya as I always called him) about doing one leg at a time as opposed to bilaterial tibs or bilateral femurs to help prevent embolism and he responded "But you are still reaming two bones, how are you reducing the risk of embolism?"

[galaxy1]

so let me get this right.

he does not do 2 tibias at the same time because hes scared of fat embolism.

he does not do 2 femurs at the same time because he is scared of fat embolism.

but he does both tibia and femur in the 1 operation because fat embolism magically disappears when its the same leg................

I smell bull crap.

You forgetting just how beneficial  mobility can be for a person who's had a serious surgery. A surgery that involves the legs, using internals that are in your bone canals and that require reaming to be done to them. My feeling on it would be that one tib one femur surgery has less chance for embolism than two tibias or two femurs.


YES!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! It's tons easier to walk with one broken leg than two that are broken.