Distraction Osteogenesis: Biologic and Biomechanical Principles

  • Christopher M. Runyan
  • Roberto L. FloresEmail author
  • Joseph G. McCarthy


Distraction osteogenesis is a bone-regenerative process in which an osteotomy is followed by gradual distraction of the surrounding vascularized bone segments, with formation of new bone within the distraction gap. This process was first described by Alessandro Codivilla at the turn of the twentieth century [1, 2]. Codivilla demonstrated the ability to lengthen the chronically deformed femur or tibia 3–8 cm following an oblique osteotomy. He did this by applying a 25–30 kg distractive force across a full extremity plaster cast, which was serially and circumferentially cut near the level of deformity. Application of traction occurred only at the time of cast adjustment, causing a gap to form, which was then filled with additional plaster. This frequently resulted in pressure necrosis due to rubbing of the cast against the soft tissues of the leg.


Fracture Healing Distraction Osteogenesis Endochondral Ossification Appendicular Skeleton Endochondral Bone Formation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Christopher M. Runyan
    • 1
  • Roberto L. Flores
    • 1
    Email author
  • Joseph G. McCarthy
    • 1
  1. 1.Wyss Department of Plastic SurgeryNYU Langone Medical CenterNew YorkUSA

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