The 6 step procedure

Candidates

Reach new heights

The complete procedure

The complete procedure consist of 6 steps.

• Consultation and evaluation

• Surgery

• Hospitalization

• Lengthening

• Consolidation

• Removal of the device

Consultation and evaluation

The initial consultation and evaluation allows for patients to tour the facility (hospital, and patient residential center) take x-rays and have physical evaluations while being able to meet other patients. Each consultation contains a meeting with staff members of the Betz team, and Prof. Dr. Betz. During the consultation he designs a specific form of treatment for each individual patient. Prof. Dr. Betz will explain in detail the devices internal/external used for limb lengthening. All aspects of the procedure will be addressed during the meeting as well as aftercare options (accommodations, physical therapy, etc.). After the consultation, patients have the opportunity to schedule an operation date. Patients will be provided with a detailed packet containing all information leading up to the operation.

Surgery

It is recommended that each patient arrives at the Betz institute 1-3 days before the surgery to have a follow up visit with Prof. Dr. Betz and team. The surgery is performed under general anaesthesia and requires approximately 2 hours per bone segment, femur or tibia. Cosmetic “bilateral” lengthening requires a total surgery time of approximately 4 1/2 hours. A small skin incision is made at the head of bone (femur or tibia) in alliance with the bone canal. The bone is then cut from the inside with a special intramedullary saw. The saw is inserted through the previous incision in order to prevent unnecessary scaring. The nail is also introduced into the bone cavity through the same incision. After the nail has been inserted it is then fixated with interlocking screws at both ends of the bone. This minimally invasive technique results in extremely little blood loss.

Hospitalization

Patients typically stay in the hospital for 6 -10 days after the operation. Starting from the 1st day after surgery, patients undergo physical therapy sessions provided by the Betz institute. Physical therapy consists of light stretching, strength training, and massage therapy. Each patient receives physical therapy sessions every day until they are discharged from the hospital. Before being discharged, all patients are taught how to properly use their crutches. This is important so that patients develop and practice proper form throughout the lengthening phase. The hospital can accommodate patients with special diet requests.

Lengthening

The lengthening phase begins during surgery in which Prof. Dr. Betz makes the initial distraction. The distraction is done in the operation so that the bone has enough distance to prevent pre-mature consolidation. Patients slowly begin lengthening by the 3rd or 4th day after surgery. The timeframe of the lengthening phase depends on the amount of gain desired per bone segment. During the lengthening phase each patient will be able to accurately control and monitor their rate of growth. Distraction is typically 1 millimeter per day (1 inch per 25 days). X-rays are scheduled for patients every 4-5 weeks during the distraction and consolidation phase. X-rays may also be scheduled on patient’s request. Typically, patients undergo physical therapy 2-4 times per week. The amount of physical therapy needed depends on each individual’s flexibility and function. Physical therapy options are available through the Betz Institute. The Betz institute provides several options for living arrangements during the lengthening phase. Patients have the option of living in the patient residential center at the Betz institute, an apartment, with a local family or to return to their home.

Consolidation

The consolidation phase begins when the desired length has been achieved. Bone consolidation or healing, is determined by x-rays in which the amount of calcium present can be determined. It is possible for patients to take vitamin/mineral supplements during the consolidation phase. The time period for this phase may be different for every patient because the rate of bone growth may be faster with certain patients. The consolidation phase takes approximately 6 to 8 weeks.

Removal of the device

Removal of the internal nail is considered an outpatient procedure and is performed 1-2 years after the lengthening. After the removal, patients have the option of returning home, staying in the hospital, or going to the residential center. Patients are able to resume physical activity in the period between the end of consolidation and the removal of the device.

For more detailed information feel free to contact us.

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Betz Institute

Heeresstr. 49

66822 Lebach

Germany

Phone:   +49 (0) 175 7815  512

Email:      info@betzinstitute.com