I think my child has an urgent, more acute problem. How can I get a quick appointment?
Please explain the situation to my assistants; they will discuss it with me. Another option is to send me an email. Both ways, I can make sure that you get an appointment in the shortest time possible.
Can I be with my child when he or she needs to stay in the hospital overnight?
If your child is younger than 12 years of age, you can stay together in the hospital room.
What happens when my child needs to stay in the hospital for a longer time and misses classes?
The Orthopedic Hospital Speising has a hospital school, and the teachers can help your child to catch up with missed curriculum, exercises, and homework.
I have a malalignment / deformity / shortening of my leg. Do I need to get x-rays?
X-rays to evaluate deformity and limb-length discrepancy need to be obtained in a standardized way. Please contact us so that we can recommend institutes that are familiar with our x-ray protocol. It is possible to get your x-rays within walking distance of my office. I can evaluate them and we can discuss them during an appointment that same day.
I come from abroad and do not have an Austrian insurance. Can I still have surgery with you?
If surgery is recommended after a detailed examination and discussion of treatment options, I can send you an estimation of cost. In rare cases, the healthcare system of your home country might cover a certain amount of the treatment cost. Our hospital administration can provide you with the necessary forms.
What is the procedure when I need surgery? How long do I need to stay in the hospital?
I can register you for surgery from my office. Hospital administration will then contact you with information about possible dates for surgery. Sometimes it is advisable to come to the hospital for a preoperative examination and assessment approximately 1 week before surgery. During that appointment, an examination by our pediatrician or internist, evaluation and informed consent from anesthesia, and standard orthopedic examination and surgical informed consent are covered. On the first day after surgery, I will perform a dressing change and discuss with you the next steps. Mobilization with or without crutches is started on the first day (or on the second day at the latest) with the help of our physical therapists. The duration of the inpatient treatment on the ward depends on the extent and complexity of surgery but is usually between 1 and 7 days. Removal of the stitches is performed 12 to 14 days after surgery in my office. Follow-up examinations can be done in my office or in the hospital’s outpatient clinic, depending on the type of surgery performed.
How quickly does the treatment need to be started?
Ideally, treatment should start the second to third week after birth. There is absolutely no need to start immediately or within the first 2 weeks. Under certain circumstances (such as pre-term birth), it is possible to delay treatment even until 3 months of age.
Is percutaneous tendo-Achilles tenotomy (pTAT) necessary?
In more than 90% of cases, this minimally invasive procedure is necessary to complete the correction. Only mild clubfoot and positional clubfoot can be corrected without a tenotomy of the Achilles tendon.
How can I wash my baby when the cast is on?
The cast cannot get wet. Therefore, you need to wash your baby with a washcloth, keeping the cast dry. However, you can bathe your baby between removal of the cast and application of the new cast. A baby bathtub and towels are available in the clubfoot clinic.
How long does the fixator need to stay in place?
Depending on the type of surgery (lengthening or deformity correction or fusion of bone and/or joint segments) the frame needs to stay attached to the bone for approximately 4 to 6 months. In adults with substantial bone lengthening of 5 to 6 cm, the time in the frame can increase to 9 months.
Can I walk with an external fixator or six-axis frame?
In the beginning, mobilization is achieved by using crutches and partial weight-bearing. During treatment, full weight-bearing is usually possible. The crutches can be discontinued when callus formation (new bone) is visible on x-rays. External fixation frames are especially stable. Rare involuntary loading above the recommended weight-bearing regime is usually without danger.
Can I shower with an external fixator or six-axis frame?
Yes, you can shower when the stitches are removed, which is usually 2 weeks after surgery. The external fixation frame does not need to be covered; water and soap can run down the involved extremity. However, the area should not be scrubbed with soap.
What can I wear with an external fixator or six-axis frame?
Wide and baggy pants can be used. Many patients remove the stitches of the trouser to add additional cloth with or without a zipper for easy access. If you like, we can put you in contact with tailors who have experience with this kind of alteration.
Is the adjustment and lengthening with an external fixator six-axis frame painful?
Adjustment and lengthening usually do not inflict pain. Occasionally, the pins and wires can lead to mild pain and irritation, especially in areas with notable skin motion around the fixation. However, pain is usually mild and can be well controlled with adequate pain medication.
Do I / does my child have to stay in the hospital during the lengthening process?
Inpatient treatment usually lasts 5 to 7 days. After the patient leaves the hospital, lengthening using the external remote control is performed at home, often with the help of family members. Physical therapy is essential for a good functional outcome, and weekly follow-up examinations in our outpatient clinic are necessary. When the goal of lengthening is achieved, the bone regenerate (newly formed bone) needs to heal and get back to its biomechanical stability. During that phase of treatment, follow-up visits are usually every 6 weeks.
Do you perform cosmetic lengthening?
Because of our hospital guidelines and mission, we do not provide cosmetic lengthening. Only in cases of short stature as found in certain metabolic disorders or syndromes is lengthening performed in the absence of limb-length discrepancy.
What is the amount of limb-length discrepancy that makes bone-lengthening procedures necessary or medically indicated?
Usually, a discrepancy of 2 cm is considered to be the threshold for surgical correction of limb-length discrepancy. Smaller discrepancies can be treated with conservative measures, such as insoles or shoe lifts.
How does distraction of the lengthening nails work? Is there a connection to the outside?
The nail is inserted completely within the bone. Distraction is performed by using a strong magnet within the nail and an external remote control that is placed against the skin. This is done three to four times a day for less than 2 minutes each time. The magnet in the external remote control activates and spins the magnet within the nail, resulting in slow distraction.