Distraction osteogenesis is a surgical procedure that lengthens bones and corrects deformities. It involves inserting a structure to stretch the bone and incrementally stretch new bone until the space is filled. A new lightweight device has been developed that uses a small motor to manage the limb deformity correction process, which is less painful and carries a lower risk of infection.
Distraction osteogenesis is a surgical procedure that lengthens a bone or a series of bones. The approach has been around since the mid-twentieth century and has made significant advances in technique since its inception. This type of orthopedic surgery can be effectively used 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 removing broken or diseased bone tissue, which created a space between healthy segments of bone. A structure designed to stretch the bone is inserted into the gap. Small screws are attached to healthy bone and incrementally stretch the new bone until the space is filled and the two bone segments heal into healthy bone once again.
Because bones can only be stretched a small amount each day, the process can take some time to complete. A typical time frame for this type of distraction osteogenesis is about 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 relievers to help deal with the discomfort that occurs from the presence of the frame and the daily stretching of the bone tissue.
Until the 1990s, this approach to distraction osteogenesis offered the best chance of recovery for patients. However, the procedure involved a lot of pain and infection was not uncommon. Scarring also occurred frequently, and patients found that the structure made it very difficult to move.
In recent years, medical technology has developed a new lightweight device that uses a small motor to manage the limb deformity correction process. The device is inserted into the bone itself, and is fixed to a stainless steel nail which is held in position with the aid of two screws. A small antenna is embedded in the skin near the nail site.
Using a handheld transmitter, the patient can activate a daily session in which the bone is lengthened to an amount considered safe. Sensors in the equipment identify when the bone is stretched to the correct limit, then the process of distraction osteogenesis ceases. The bone can continue to solidify after reaching the correct length. Approximately two years after bone lengthening, the equipment can be safely removed.
This new method of distraction of osteogenesis is not in common use worldwide. Developed in Germany by Rainer Baumgart and Augustin Betz in the latter part of the 1990s, most of the procedures using this equipment took place in that country. However, the device was used in parts of Asia and Australia. While considerably more expensive than more traditional methods, this new form of distraction osteogenesis is said to carry a lower risk of infection and cause less pain for the patient during the actual bone lengthening process.
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