ABSTRACT
Distraction osteogenesis (DO) is a technique to create new bone by gradually separating the segments following an osteotomy. It was first described by Codivilla in 1905 and later refined by Ilizarov in the long bones and McCarthy for the craniofacial skeleton. DO can be achieved with either an internal or external device. Increasingly, semi-buried internal devices are preferred, having fewer complications and being better tolerated and less bulky than external devices. Pre-surgical planning is crucial to a successful outcome in DO. Imaging should be appropriate to the relevant case, although will commonly include an orthopantomogram, fine-cut CT with 3D reconstructions and scanned or physical study models. Intraoperative complications include injury to neurovascular structures, tooth buds, incomplete corticotomy and difficulty with planned distractor placement position. These can be mitigated with good pre-surgical planning. Complications following this procedure are seen in 20–35% of cases, the majority of which relate to relapse, infection, pain and inappropriate vector distraction.
