The distraction process

What is distraction?

Distraction osteogenesis, or mandibular bone lengthening, is a process to treat underdeveloped jaws in children.

Why should I bring my child to Children’s Hospital of Wisconsin?

In 1994, Children's Hospital of Wisconsin surgeons were the first in North America and Europe to perform distraction on a series of neonates born with underdeveloped lower jaws. This technique proved to be very effective. Since then, we have used distraction to treat more than 150 children with varying diagnoses and syndromes with consistent success.

How long has distraction been used to treat underdeveloped jaws?

While distraction has been used to treat craniofacial disorders for more than 20 years, it has been used much longer by orthopedic surgeons to lengthen long bones, such as those in the arms and legs.

How does distraction work?

A child's bones, especially facial and skull bones, are able to be molded in the way they form because they are actively growing. Distraction takes advantage of a child's ability to grow bone easily. When a child's bone is cut or broken, it rapidly heals by producing more bone. When surgeons make a small cut in a child's jaw and create a space between the two ends, bone grows in between. By continuing to expand the space each day and allowing bone to grow, surgeons can create more bone. The jaw can be lengthened exactly the right distance for each child's need. This can be very helpful for children with a number of craniofacial disorders.

What happens during the distraction process?

Surgeons begin by inserting a series of pins into the bone to control the segments after the bone is cut. Expansion can continue until the necessary distance is reached, which usually takes 2 to 3 weeks. Surgeons then stop the expansion, and the bone becomes solid in 4 to 10 weeks.

Is the distraction process painful?

The distraction process is far less painful than it might seem. If your child undergoes distraction, we will do everything we can to make your child as comfortable as possible.

How long does recovery take?

Children recover quickly from the initial placement of pins. They are then able to return to most normal childhood activities. During the expansion process, children are able to eat soft foods normally, even while the pins are in place. Most do not require hospitalization or extra nutritional support, like a feeding tube. In 4 to 10 weeks, the bone becomes solid. We then remove the device, and the bone lengthening is complete.

Will my child have a scar?

Scarring is minimal and is dependent on the type of distraction done. It also will fade in time.

Will my child need additional surgeries?

In most cases, one distraction is the only procedure your child will need to correct the jaw and airway. If your child’s shortened jaw was part of a syndrome or other craniofacial disorder, he or she may need more surgery to correct problems (such as cleft palate) that are associated with that syndrome or disorder.

Are there any risks?

No surgery is without risks. However, with experience, we have been able to reduce possible complications to the point where this procedure has fewer complications than procedures like tracheostomy placement. During surgery, correct placement of the pins is critical. This includes properly identifying the area that needs to be moved and the strongest area of bone that can withstand the process.