Distraction osteogenesis lengthens or reshapes bone by cutting it and then pulling the two ends apart a fraction of a millimetre each day. New bone forms in the widening gap, and the whole process takes months rather than weeks.
Distraction osteogenesis grows new bone by taking advantage of how bone heals. The surgeon divides the bone and fits a device that separates the ends very gradually, usually less than a millimetre a day. Fresh bone fills the widening space as it is pulled, and once the target length is reached the new bone is left to harden over several more months.
When a bone breaks, the body lays down soft repair tissue between the ends and then turns it into bone. Distraction osteogenesis uses that same process on purpose. The surgeon divides the bone carefully, preserving its blood supply, and fits a device that holds both segments. After a short waiting period the device is turned a little each day, opening the gap by a fraction of a millimetre at a time.
Because the separation is so gradual, the repair tissue is stretched rather than torn, and it continues to convert into bone as the gap widens. Skin, muscle, nerves and blood vessels adapt along with it. Pulling faster does not save time. It leaves a gap the body cannot fill and produces a weak or absent bridge that has to be treated all over again.
Devices vary. Some sit outside the limb or face on pins, while others are placed inside the bone or under the skin. In the jaw and midface the technique is used to bring bones forward and improve the airway or the bite. Once the planned length is reached, the device stays in place while the new bone hardens, and only then is it removed at a second operation.
This technique suits patients who need a large amount of new bone and who can commit to a long process. It asks a great deal of the patient and the family, and that has to be weighed honestly.
Scans and measurements set out how much length is needed, in which direction, and where the bone should be divided. Planning is detailed, because the direction of pull is fixed once the device is attached.
At the first operation the bone is divided with care to protect its blood supply, and the distractor is secured to both segments. The wound is closed and the device is left inactive at first.
Turning does not start immediately. A short latency period allows the early repair tissue to form between the ends, which is the material that will later stretch into new bone.
The device is turned a small amount each day, usually divided into several turns. Progress is checked in clinic, and the rate may be adjusted if bone forms too slowly or too quickly.
Once the target is reached, the device stays in place while the new bone hardens over several months. It is then removed at a second, shorter operation.
You recover from the first operation, learn how to clean pin sites, and are taught how to turn the device. Turning usually begins towards the end of this period rather than straight away.
Daily turning continues at home with clinic reviews and imaging. Mild stretching discomfort is normal, and physiotherapy keeps nearby joints moving while the bone lengthens.
Turning stops and the device stays on while new bone hardens. Activity gradually increases within limits set by your team, guided by what the scans show.
A second short operation removes the device. Strength and confidence build over the following months, and physiotherapy continues until function has settled.
Distraction can produce a substantial gain in bone length, but it asks for patience and consistency. New bone sometimes forms more slowly than hoped, and the plan may be adjusted or extended. Small differences in direction or a mild relapse can occur, and a further procedure is occasionally needed to refine the result. Scars remain where pins or the device were placed. Most patients find the functional gain worth the long process.
This is a long treatment with a device attached to the body, so complications are not unusual and most are manageable when caught early.
Daily care of the pin sites and steady turning are the two things that matter most at home. Both are taught before you are discharged.
Turning too fast outruns the body. The gap then fills with fibrous tissue instead of bone, and treatment takes far longer to put right.
The longest phase begins after lengthening stops. New bone needs months in place to harden before the device can safely be removed.
It is widely used in the jaw and midface as well, where it can improve the bite and the airway in craniofacial conditions.
Mild pin site irritation is common and usually settles with careful cleaning. It should still be reported, since early treatment stops it becoming a deeper infection.
Elegance Clinic in Surat sets out the whole timeline of a distraction before treatment starts, so families understand the commitment involved. Dr. Ashutosh Shah reviews progress regularly and adjusts the rate according to what the imaging shows.
Technique pages do not carry their own price, because the cost depends on the treatment the technique is used within. Distraction is priced as part of the jaw, craniofacial or limb reconstruction it belongs to, and that estimate covers both the fitting and the removal operation. Please see the relevant treatment page and ask for a written estimate at consultation.
These are the questions that come up most often in consultation. If yours is not here, send it on WhatsApp and the team will reply, usually the same day.
Ask your question →There is no separate technique price. Costs sit within the reconstruction it forms part of, and should cover both operations, the device, imaging and follow up. Ask for a written estimate at consultation so the whole treatment period is accounted for.
Several months from the first operation to removal of the device. Lengthening itself is the shorter phase, while the consolidation period during which new bone hardens takes considerably longer and cannot safely be rushed.
Most people describe a stretching sensation rather than sharp pain, and it settles between turns. Discomfort that becomes severe should be reported, because the rate may need adjusting. Prescribed medication is used during the more active phase.
Many people continue with daily life while the device is in place, adapting clothing and activity around it. Contact sports and heavy physical work are avoided. Your team will advise based on the site being lengthened.
The rate of turning is reduced or paused so the body can catch up. Imaging at each review guides this. If bone formation remains poor, a bone graft or a further procedure may be discussed.
Yes, one to fit the device and another to remove it. The removal operation is usually shorter and simpler. In some cases an internal device is left longer or requires a slightly different removal approach.
Discuss how much correction you need, what a simpler graft could achieve, and whether you can manage daily turning and frequent reviews. Bring scans and previous operation notes so the plan can be assessed properly.
Seeing patients from across the city and beyond: read about the practice on the plastic surgeon in Surat page, or check what a written estimate covers on the costs and insurance page.
