Devices & Techniques: Bone Transport
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The first report of the clinical application of bone transport was presented in 1995 by Costantino and coworkers (Costantino et al., 1995). In December 1992, they had successfully applied transport distraction to restore the continuity of a mandibular defect formed as result of cancer resection following radiation therapy. A year later, Block presented the results of four cases with bone transport using a Synthes lengthening device (Synthes Maxillofacial, Paoli, PA, USA) with two double-pin clamps adjusted for this specific application (Block et al., 1996a). Distraction at a rate of 0.5 mm twice a day was performed after 7 days of latency and was followed by 8 weeks of consolidation.

Since these first reports, bone transport has been sporadically used to treat bone defects caused by trauma or bone resection (Labbe et al., 1997; Sawaki et al., 1997b; Yonehara et al., 1997). Distraction of bone segments in these cases has allowed mandibular reconstruction without bone grafting. Importantly, mandibular distraction recreates the alveolar ridge with its attached mucosa.

FIG. 3.2.7. Costantino's extraoral appliance for mandibular bone transport. The device consisted of a semicircular external frame attached by two pairs of pins to the mandibular segments and a transport tram connected to the transport segment. © 1995 by W.B. Saunders. Reproduced with permission from Costantino PD, Johnson CS, Friedman CD, Sisson GA. Bone regeneration within a human segmental mandible defect: A preliminary report. Am J Otolaryngol 1995;16:56-65.

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