What is Distraction Osteogenesis?

Distraction osteogenesis is a surgical procedure that makes it possible to lengthen a bone or series of bones. The approach has been around since the middle of the twentieth century, and has advanced in technique considerably since its inception. This type of orthopedic surgery can be used effectively in the treatment of limbs as well as in helping to correct deformities related to the structure of the skull.

Sometimes referred to as callus distraction or osetodistraction, distraction osteogenesis was first developed by a Russian orthopedic surgeon named Gavriel Ilizarov. Perfected by Ilizarov in 1951, this method of skeletal reconstruction focused on the removal of shattered or diseased bone tissue, which created a gap between the healthy segments of the bone. A framework created for lengthening the bone is inserted into the gap. Small screws are attached to the healthy bone and incrementally stretch the new bone tissue until the gap is filled and the two segments of bone heal into one healthy bone once more.

Because the bones can only be stretched a tiny amount each day, the process can take some time to complete. A typical time frame for this type of distraction osteogenesis is roughly four months, and possibly longer, depending on how quickly the restored bone is able to heal. During that time, the patient is provided with pain killers to help deal with the discomfort that occurs from the presence of the frame and the daily stretching of the bone tissue.

Up until the 1990s, this approach to distraction osteogenesis offered the best chances of recovery for patients. However, the procedure involved a great deal of pain, and infection was not uncommon. Scarring also occurred frequently, and patients found that the framework made it very difficult to move around at all.

In recent years, medical technology has developed a new lightweight device that makes use of a small motor to handle the process of correcting limb deformity. The device is inserted into the bone itself, and is attached to a stainless steel nail that is held in position with the aid of two screws. A small antenna is embedded in the skin near the site of the nail.

Using a handheld transmitter, the patient can activate a daily session in which the bone is stretched within what is considered a safe amount. The sensors in the equipment identify when the bone is stretched to the proper limit, then ceases the process of distraction osteogenesis. The bone is allowed to continue solidifying after the proper length is reached. Roughly two years after the bone lengthening, the equipment can be safely removed.

This newer method of distraction osteogenesis is not in common use around the world. Developed in Germany by Rainer Baumgart and Augustin Betz in the latter part of the 1990s, most of the procedures using this equipment have taken place in that country. However, the device has been utilized in parts of Asia and Australia. While considerably more expensive than more traditional methods, this newer form of distraction osteogenesis is said to carry a smaller risk of infection and cause less pain for the patient during the actual process of bone lengthening.