Mandibular Lengthening: Orthofix
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Jay M. Pensler, MD

Introduction

In 1905, Codivilla described the concept of osteodistraction (Codivilla, 1905). Technical problems associated with distraction of long bones were later circumvented by several investigators, most notably, Ilizarov and De Bastiani (Ilizarov, 1988; Ilizarov & Ledyaev, 1992; De Bastiani et al., 1987; Snyder et al., 1973;  Michieli & Miotti, 1977; Karp et al., 1990; Karp et al., 1992; Pensler et al., 1995; Costantino et al., 1993). McCarthy et al., in 1992, first described distraction of the hypoplastic mandible in humans (McCarthy et al., 1992). The deficiencies that distraction addresses are not isolated to the skeleton but also affect the soft tissues, including the skin, musculature and neurovascular structures. As our experience with this technique for the correction of facial deformation has expanded, we have modified our management of patients presenting with skeletal and soft tissue deformation of the face as described herein.