Distraction osteogenesis correction for tissue defects of cleft palate: histological, immunohistochemical and fluorescent labelling study

Motorcycle spoke injuries involving the soft tissue, Achilles tendon, and calcaneal defects are rare in children. Currently, calcaneal defects are very challenging to treat. Multiple methods have been used in clinical practice; however, an effective treatment has yet to be established, especially when Achilles tendon and soft-tissue defects are also present. It is important to address this condition, because the calcaneus plays a key role in standing and gait. Unsatisfactory treatment of calcaneal defects may significantly decrease patients' quality of life (eg, by limiting mobility). In this article, we report the effective treatment of calcaneal defects in four children using distraction osteogenesis with an external fixator framework designed by the authors. From May 2014 to May 2015, four children (age range, 6–11 years) with defects of the Achilles tendon, soft tissue, and calcaneus resulting from a motorcycle accident were treated at our hospital. The Achilles tendon and soft-tissue defects were treated with second-stage reconstruction. In the third-stage surgery, osteotomy of the residual calcaneus was performed. A customized external fixator was used to lengthen the calcaneus at a rate of 1.5 mm/day in the posterior direction and reposition it by 40° in the inferior direction. In all four children, the calcaneus was lengthened by 5 cm. Distraction osteogenesis through external fixation is effective for restoring the length, width, and height of the calcaneus in children.

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PSEF 2004 Research Fellowship ??? Lyndon Peer: Sutural Distraction Osteogenesis for the Treatment of Cleft Palate Disease

Plastic & Reconstructive Surgery ◽

10.1097/00006534-200509011-00056 ◽

2005 ◽

Vol 116 (Supplement) ◽

pp. 55

Author(s):

Miroslav S. Gilardino ◽

Mark C. Martin ◽

Hanni Sino ◽

Janet E. Henderson ◽

H Bruce Williams

Keyword(s):

Cleft Palate ◽

Distraction Osteogenesis ◽

Research Fellowship

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Anterior Maxillary Segmental Distraction Osteogenesis for Treatment of Maxillary Hypoplasia in Patients With Repaired Cleft Palate

Journal of Craniofacial Surgery ◽

10.1097/scs.0000000000005150 ◽

2018 ◽

Vol Publish Ahead of Print ◽

Keyword(s):

Cleft Palate ◽

Distraction Osteogenesis ◽

Maxillary Hypoplasia

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Pediatric Feeding in Infants With Pierre Robin Sequence Following Mandibular Distraction Osteogenesis

Perspectives of the ASHA Special Interest Groups ◽

10.1044/persp1.sig13.5 ◽

2016 ◽

Vol 1 (13) ◽

pp. 5-9

Author(s):

Kelly Mabry

Keyword(s):

Cleft Palate ◽

Airway Obstruction ◽

Distraction Osteogenesis ◽

Pierre Robin Sequence ◽

Mandibular Distraction ◽

Post Surgery ◽

Feeding Experience ◽

Robin Sequence ◽

Mandibular Distraction Osteogenesis ◽

Pierre Robin

Pierre Robin sequence (PRS) causes anomalies that can include micrognathia, cleft palate, and glossoptosis. At birth, infants typically present with a small mandible (micrognathia) which displaces the tongue posteriorly and causes breathing difficulties due to airway obstruction. A large, U-shaped cleft palate is often associated with this condition and the combined phenotype can be seen in isolation or in conjunction with a syndrome. In the neonatal period, management of PRS focuses on airway obstruction and feeding through conservative positioning techniques that are often successful. However, infants that do not respond to conservative measures require surgical intervention such as tongue-lip adhesion, tracheostomy, or mandibular distraction osteogenesis (MDO) to manage their airway. While each of these surgical procedures have been used effectively, the process of MDO has become the definitive technique to surgically correct the airway obstruction in PRS by lengthening the mandible, which also brings the tongue forward and out of the airway. Feeding intervention is directly related to the resolution of micrognathia which in turn advances the tongue base anteriorly, resolving the glossoptosis and airway obstruction. The infant's feeding experience, including pre-surgery and post-surgery considerations, are discussed.

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