I know I have done a an extensive review of all the types of surgical methods out there that are used to extend bones and this specific method was mentioned and discuseed in passing. However, this post will look deeper into the Method.
The specific name for the surgery is called “The Fitbone Surgery Method”. It was developed by Dr. Betz of Germany and it is what people on the Make Me Taller forums call an internal method. The oldest and original way to increase one’s bones was from the ilizarov method, which involved putting a fixator (looks like a cylindrical clamp) on one’s long bone and hold it in place with wires and slowly move the bones apart from each other to increase the bone length. The method was “external” because the device was on the outside of the leg bone.
For this method, the fitbone is an internal method. A metal rod is placed inside the patient’s long bone and there is a remote controlled motorized device that turns the rod which increases the rod’s length. Since the long bone is attached to the rod, the long bone increases along with it.
If you would like to get a broshure/flyer for your convenience, just click HERE to get almost all of your questions for the Fitbone Surgery Method answered.
From the Wikipedia article on Distraction Osteogenesis HERE
A form of surgery involving an intramedullar, fully implantable, electronically-motorised limb-lengthening implant, called “Fitbone”, is a technologically advanced, though relatively complex, device.
Developed in Germany by Augustin Betz and Rainer Baumgart, the first successful operations were performed in 1996 and the technique was patented in 1997. Thus far, most of the surgeries using this method have been performed in Munich, Germany by Baumgart and Peter Thaller. The first successful surgeries in Asia have been performed since 2001 by Dr Sarbjit Singh in Tan Tock Seng Hospital, Singapore, and Dr Sittiporn, Bumrungrad Hospital, Bangkok. In December 2005 Fitbone surgery was done in Malaysia at the Mahkota Orthopaedic Reconstruction and Limb Lengthening Center, Melaka by Thirukumaran Subramaniam and Jeyaratnam T Satkunasingam. Dr. Bruce Foster of Adelaide, Australia, chairman of the “Bone Growth Foundation” — a charity established with the aim of helping children with crippling bone growth problems — is currently the only surgeon that uses the “Fitbone” device in the southern hemisphere.
Fitbone comprises a telescopic nail implant that can extend, powered by an electric motor and controlled by a receiver with an antenna that is buried under the skin; the receiver in turn is controlled by a hand-held radio-frequency transmitter. The procedure for lengthening the lower leg is as follows:
- A two-centimetre incision is made at the patient’s knee, and a reamer is used to create enough space in the bone for a stainless steel nail.
- The bone is cut about 14 cm below the knee from the inside with an internal saw.
- The stainless steel nail is held in place by two screws. The top of the nail is attached to a tiny, plastic-encased receiver that is placed under the skin.
- The patient controls the lengthening process. By pushing a button on the transmitter when it is placed against the antenna, the built-in motor extends the nail one millimetre per day. When the leg has grown to the desired length, lengthening stops, and the bone is allowed to solidify.
- The device can be removed about two years after the initial surgery.
This procedure, however, comes at a price. While the Ilizarov external fixator costs approximately US$4,000, and the ISKD implant about US$8,000, the Fitbone device carries a price tag of roughly US$15,000 (all prices exclusive of surgery costs).
The Bliskunov device is currently not available.
Osteotomy “cutting of the bone”
Prof. Dr. Betz’s innovative technique is one that separates him from other limb lengthening surgeons.
The osteotomy or “cutting of the bone” is a crucial part of the operation. Prof. Dr. Betz uses an intremedullary saw to perform the osteotomy which eliminates the risk of cutting or damaging the surrounding soft tissue. The internal saw is introduced through the same incision made for the internal device in order to prevent any unnecessary scarring. This is the reason for extremely little blood loss, and small scar formation. This technique is unique in that most other limb lengthening surgeons cut the bone from the outside causing more scars and soft tissue damage. The principle of an internal osteotomy is to keep the inner and outer layer of the bone and surrounding soft tissue intact.
Betz institute technique
– Internal cutting device
– Osteotomy performed from inside the bone
– Only one incision for the distraction device and intremedullary saw
– No additional incisions for cutting the bone
– No unnecessary damage to the surrounding soft tissue
– No disruption to the outer layer of the bone segment
Traditional techniques used by most surgeons
– External cutting device
– Osteotomy performed from the outside of the bone
– Additional scarring for the osteotomy
– Possible damage to the surrounding soft tissue
– Disruption of the outer layer of bone which may cause nonunion
Entry point for the internal device
The insertion of the nail is an extremely important part of the procedure. Prof. Dr. Betz creates a very small incision at the top of the intended bone segment (femur or tibia). The benefit of Prof. Dr. Betz’s entry point is that it is safer and aesthetically better for the patient. Prof. Dr. Betz inserts the internal device through the top of the femur near the side of the hip because it is a direct route to the bone canal. The entry point for the tibia is made below the knee in order to make a direct route into the bone canal. For the femur, many other surgeons insert the internal nail through the buttock which may cause damage to muscle and soft tissue as well as create unattractive scars in an undesirable location.
Betz institute technique
– Entry point at the top of the bone segment near the side of the hip for femur
– No cutting through muscle or unnecessary damage to the soft tissue
– No need to cut through the buttock to introduce the internal device
– No scarring on the buttock
Traditional techniques used by most surgeons
– Entry point through the buttock for femur
– Unnecessary damage to muscle and other soft tissue
– Undesirable scars on the buttock
FITBONE (fully integrated telescopic bone) nail is a distraction device powered by an internal engine which is activated by a hand held remote. The remote activates distraction by sending messages to the receiver implanted below the skin.
The FITBONE does not allow full weight bearing; therefore patients are required to use a wheelchair during the entire lengthening phase.
FITBONE allows for a 5 cm. (2 inch) gain in one bone segment.
The Fitbone System, is similar in function to a telescopic car antenna.
The nail consisting of 2 parts is powered by a minute engine gear device which draws the telescope apart by applying force of up to 200 kg, during which the extension is externally steered via electronic impulses. The Fitbone nail elongation is propelled by a highly sensitive epicyclic gear which has been manufactured by Wittenstein Intens, a company specialising in high precision gearing.
Both implants are inserted through one single small entrance simultaneously elongating the thigh and lower leg. This entrance point “Model Entrance Point” was developed by Prof. Betz. All that remains is a tiny scar in a natural skinfold. Even the artificial growth juncture is inserted as gently as possible via an internal access point.
Our aim is always to achieve an identical natural reconstruction.