Lengthening the Human Mandible by Gradual Distraction

We present 19 ray lengthenings in 14 patients done with a small external fixator. In six cases the thumb was lengthened and in the other 13 cases, other digital rays. The most frequent reason for lengthening was an amputation sustained in a work accident. All the lengthenings were done by an osteotomy and subsequent gradual distraction with a small external fixator. The mean lengthening achieved was 20 mm (range, 0–32). An iliac-crest graft was needed in nine cases, corrective osteotomy in five cases and a deepening of the web in the six cases of thumb lengthening. In five cases an additional technique was needed to achieve bony consolidation. We have analysed the functional results and the ability to perform activities of daily living and resume employment. Although most of the patients had multiples injuries, the results have been very favourable, achieving a very high level of patient satisfaction.

Download Full-text

Correction of micrognathia attributable to ankylosis of the temporomandibular joint using a gradual distraction technique: Case report

Journal of Oral and Maxillofacial Surgery ◽

10.1053/joms.2000.7276 ◽

2000 ◽

Vol 58 (12) ◽

pp. 1415-1418 ◽

Cited By ~ 11

Author(s):

Yoshiyuki Yonehara ◽

Tsuyoshi Takato ◽

Takafumi Susami ◽

Yoshiyuki Mori

Keyword(s):

Case Report ◽

Temporomandibular Joint ◽

Gradual Distraction

Download Full-text

Frontoorbital advancement by gradual distraction

Journal of Neurosurgery ◽

10.3171/jns.1998.89.6.1058 ◽

1998 ◽

Vol 89 (6) ◽

pp. 1058-1061 ◽

Cited By ~ 67

Author(s):

Shinichi Hirabayashi ◽

Yasushi Sugawara ◽

Atsushi Sakurai ◽

Kiyonori Harii ◽

Susam Park

Keyword(s):

Surgical Treatment ◽

Illustrative Case ◽

Content Type ◽

Craniofacial Structure ◽

Number Of Patients ◽

Frontoorbital Advancement ◽

Coronal Synostosis ◽

A New Technique ◽

Partial Resorption ◽

Gradual Distraction

✓ A substantial number of patients with coronal synostosis who undergo frontoorbital advancement still require additional surgical treatment to correct increased intracranial pressure or unsatisfactory craniofacial structure. However, frontoorbital advancement currently requires elevation of the frontal as well as the orbital bone, which can result in a fragile dura mater and partial resorption of the advanced bone. Thus the dura is easily torn by dissection and the advanced bone is further resorbed and deformed during repeated craniofacial operations. To avoid these drawbacks and to create an easier second surgical treatment via the intracranial approach, a new technique for frontoorbital advancement is presented. In this technique frontoorbital bone is advanced as a single unit, without elevation from the underlying dura, by means of gradual distraction. The details of the technique and an illustrative case are reported.

Download Full-text

Distraction Osteogenesis for Micrognathia in Cipto Mangunkusumo Hospital : A Case Series

Jurnal Plastik Rekonstruksi ◽

10.14228/jpr.v2i1.127 ◽

1970 ◽

Vol 2 (1) ◽

Author(s):

Grace Boaz ◽

Prasetyanugraheni Kreshanti ◽

Siti Handayani ◽

Kristaninta Bangun

Keyword(s):

Distraction Osteogenesis ◽

Rare Case ◽

Young Patients ◽

Case Series ◽

Genetic Syndromes ◽

Mandibular Hypoplasia ◽

Distraction Device ◽

Mandibular Body ◽

Inferior Border ◽

Gradual Distraction

Background: Micrognathia is usually associated with genetic syndromes, characterized by mandibular hypoplasia causing a receding chin. The overall incidence of micrognathia was 1 per 1600 births, makes it a rare case. Severe micrognathia can be a neonatal emergency due to airway obstruction by the tongue in the small oral cavity. One method for correcting micrognathia is distraction osteogenesis. Lack of experience due to rare incidence of case, expensive cost of distraction device and technical complexity of the operation can be obstacles to this management. Patient and Method: We report two cases of micrognathia corrected with distraction osteogenesis conducted in Cipto Mangunkusumo Hospital from 2011-2012. The method consists of implantation of bilateral distraction device to the inferior border of the mandibular body. The patients then followed postoperatively. Result: Mandibular lengthening by gradual distraction is a proper method for young patients with micrognathia. Despite our minimal experience and intricate kind of method, we are trying to improve our skill in the future. Summary: Distraction osteogenesis is one method for correcting congenital mandibular hypoplasia.

Download Full-text

One-stage correction of multiple brachymetatarsia and hallux valgus with calcaneal autograft

Scientific Journal of the Foot & Ankle ◽

10.30795/scijfootankle.2018.v12.833 ◽

2018 ◽

Vol 12 (4) ◽

pp. 342-46

Author(s):

Felipe Almeida Rocha ◽

Henrique Mansur ◽

Rubens Theodoro Meira ◽

Lucio Gusmão ◽

Cesar Barbosa Gonçalves ◽

...

Keyword(s):

Bone Graft ◽

Hallux Valgus ◽

Expert Opinion ◽

External Fixator ◽

Single Procedure ◽

One Stage ◽

Premature Closure ◽

The Right ◽

Bone Elongation ◽

Gradual Distraction

Brachymetatarsia is the shortening of the metatarsus caused by congenital premature closure of the metatarsal physis. In general, the patient presents a shortened and dorsally situated toe causing metatarsalgia in addition to aesthetic effects. The aim of surgery is to improve the symptoms andaesthetics through bone elongation and rebalancing of the metatarsal formula. This elongation may be performed through gradual distraction with an external fixator or a single procedure with a bone graft. We report a case of bilateral brachymetatarsia of the 3rd and 4th metatarsals associated with hallux valgus and deformities in the 2nd toe, in which surgery was performed on the right foot with a calcaneal autograft.Level of Evidence V; Therapeutic Studies; Expert Opinion.

Download Full-text