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Stages of Distraction Osteogenesis

STAGES OF DISTRACTION OSTEOGENESIS

Distraction osteogenesis (DO) is a surgical method for gradually adjusting bone length or position through careful cutting and slow separation of fragments using a distraction device. Executed in stages, this procedure ensures proper bone healing.

Stages of Distraction Osteogenesis:

  1. Osteotomy: The initial stage involves surgically cutting the bone (osteotomy) with precision to achieve the desired lengthening or repositioning.

  2. Latency Period: Following the osteotomy, a crucial 5-7 day latency period allows bone cells to stimulate new matrix formation, promoting healing and stabilization before distraction begins.

  3. Distraction Phase: The bone fragments undergo gradual separation using the distraction device, turned at a rate of approximately 0.5-1 millimeter per day. This phase lasts weeks or months, depending on the required adjustment.

  4. Consolidation Phase: Once the desired adjustment is achieved, the distraction device remains in place for several months, allowing the new bone matrix to mineralize and harden, creating a robust union of bone fragments.

  5. Device Removal: The final stage involves the removal of the distraction device, typically performed under local anesthesia once the bone union is strong and displacement risks are minimal.

Additional Considerations:

  • Monitoring: Throughout the process, close surgeon monitoring ensures proper bone healing and identifies potential complications.

  • Physical Therapy: Post-distraction phase, physical therapy may be recommended to regain range of motion and strength in the affected area.

  • Recovery: The recovery time varies based on the surgery’s extent and individual factors, but patients can generally anticipate a return to normal activities within a few months.

Osteotomy

Osteotomy

The surgery in which the bone is cut and the distractor device is fixed

Latency Period

Latency Period

The time between the surgery and start of active distraction process

Distraction Period

Distraction Period

The period during which the distractor device is turned at a rate of 1 mm per day till the desired length is reached. The cut bone segments move apart.

Consolidation Period

Consolidation Period

Activation of the distractor is stopped and the bone formed in the gap is allowed to mature. The distractor device is removed at the end of this phase.

Remodelling Phase

Remodelling Phase

Remodeling of bone occurs after the distractor device is removed

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