MANDIBULAR ELONGATION AND REMODELING BY DISTRACTION - A FAREWELL TO MAJOR OSTEOTOMIES

A modified technique for mandibular distraction is reported: An obliqu e corticotomy is made in the external cortex of the mandible at the le vel of the genial angle. Two intraosseous stainless steel pins are ins erted and are joined by a softer distraction screw. We make two cortic otomies, one horizontal and one vertical, and insert three pins to ach ieve bidirectional distraction when the mandibular body and the ascend ing ramus are hypoplasic. This procedure has been used in 87 patients with unilateral hemifacial microsomia and 19 patients with bilateral m andibular hypoplasia. A mean elongation of 19 mm was obtained in the u nilateral group. In the bilateral cases a mean vertical elongation of 7.5 mm and a mean horizontal elongation of 14 mm were obtained. A grea t improvement of the facial asymmetry was achieved in all the patients . The follow-up in this series varies from 3 months to 3 1/2 years (me an, 19 months in unilateral cases and 12 months in bilateral cases). N o relapses have been observed.