Distraction osteogenesis

Callus distraction, even distraction osteogenesis is a surgical procedure for lengthening bones. The bone is cut to be extended surgically and the two halves are moved apart by means of an external fixator for weeks slowly and continuously along its longitudinal axis. Between the halves thereby forming new bone.

Historical Development

Hopkins and Penrose 1889 extended intraoperatively a bone by introducing a bone block. In 1905 led a Alessandro Codivilla operative techniques for extending the lower extremities. These early surgical techniques have a high complication rate, especially during the stage of bone healing. It was often the goal, which does not reach the bone lengthening.

The breakthrough came thanks to a system established by the Russian orthopedic surgeon Gavril Ilizarov technique: Ilizarov developed a procedure based on the biology of bone and the ability of the surrounding soft tissues to regenerate under tension. This was done using a special external fixator, the Ilizarov ring fixator -. Although the actual type of complications did not change ( infection as a common complication particularly at the entry points of the external fixator, pain, irritation of nerves and soft tissues ) were incidence and severity of complications with art can be reduced by Ilizarov. The surgery was safer and better achieve the goal of bone lengthening.

By fully implantable systems as the Fitbone ® distraction nail infection risk is virtually eliminated since there is no connection during the distraction phase of the system through the skin to the outside. The risk of infection is therefore limited to the operations in which the intramedullary nail is explanted in or. By a motor in the system of severed bone is distracted daily by up to 1 millimeter. Both the energy supply and control of the system takes place externally by means of induction, and can be carried out by the patient himself. In addition to the reduced risk of infection, this type of callus is a much lower burden on the user, since clearly are fewer scars and no special care is needed. It can also be begun during treatment with physiotherapy, what the treatment progress accelerated, thus reducing potential downtime.