Distraction osteogenesis (DO) is a biological process that promotes bone formation between cut surfaces of bone segments while continuous traction is applied to separate the bony fragments. The goal of distraction osteogenesis (DO) is to make bones longer. The surgery uses the body’s ability to heal bones to generate new bone where it is needed.
Distraction osteogenesis is a technique in which cuts are made in bones and specialized devices (distractors) are placed. Healing is allowed to begin and then the distractors are turned (activated) to move the cut ends of the bones away from one another slowly over time. This creates new bone in the gap and allows for generation of new bone and repositioning of the bones also.
This procedure uses specialized devices called cranial distractors to move the bones of the back of the skull very slowly. Cranial distraction allows for more significant reshaping and expansion of the space inside the skull by slowly stretching the scalp over time. The scalp no longer determines the amount of cranial expansion. Now the amount of expansion is only determined by what the patient needs. In addition, new bone forms in the gaps of the cut skull bones. The skull bones don’t have to be removed or reshaped which minimizes the morbidity of the surgery compared to open cranial vault surgery.
The gradual distraction of the osteotomized fragments allows the surgeon unparalleled control in gradually increasing the gap between the cranioplasty fragments, and the consolidation period helps to prevent relapse of the fragments back to their original positions.
Posterior expansion allows for an increase in intracranial volume and with minimal cosmetic detriment as the all too visible frontal areas are left undisturbed.
One of the major advantages of a distraction technique using miniaturized hardware. Miniaturized distractors allow precise control of the rate of distraction, the amount of distraction, and when to stop distraction.
Parents should consider; hardware that will be visible throughout the distraction process, parents will have to turn the distractors and be hands on in this procedure, the possibility of skin breakdown over the hardware and the possibility of hardware breakage.
Distraction Osteogenesis is considered a more minimally invasive procedure. The procedure will require two surgeries, the second to remove the hardware.
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