Distraction Osteogenesis Part 1: History and Uses in the Craniofacial Region

Distraction osteogenesis (DO) originated as a method to repair skeletal deformities and large, non-healing, segmental bone defects resulting from injuries suffered by Russian soldiers during World War II. The method, which increases the length of bones by causing new bone to form between two surgically separated segments of bone, was discovered inadvertently by a non-surgically trained general practitioner, Gavril Ilizarov, in a small town in Siberia. Subsequently, Professor Ilizarov became a renowned orthopaedic leader due to the revolutionary advancements in bone management arising from DO. However, the discovery of DO in the mid-20th Century did not initially reach Western Europe due to delays caused by the Cold War.¹

Craniofacial distraction was first reported in 1973 by Snyder and co-workers, who demonstrated resection and subsequent reconstruction of a section of canine mandible using distraction with an extra-oral fixation device.² Translation of the technique to human craniofacial structures came some years later, when successful mandibular distraction was described in four children with congenital mandibular hypoplasia in 1992.³ A report of more extensive three-dimensional movement using miniaturized distraction devices in a 4-month-old boy with left-sided craniofacial microsomia in 1995 emphasized wider potential applications for the technique.⁴ In the 20 years since, numerous reports of craniofacial distraction osteogenesis have been published.