Spring-Assisted Distraction: Principles and Techniques

Abstract

Calvarial distraction resulting in osteogenesis within the bone gaps created is an established technique in craniofacial surgery. Multiple distractor types are utilized, both internal and external to achieve this aim. Spring-like devices have increasingly been used as distractors for over two decades now, with positive results and an acceptable morbidity profile. Advantages include the minimalistic nature of the surgeries and the reduced socioeconomic costs. Furthermore, distraction over larger distances may be achieved compared to other types of distractors. This is coupled with a reduced degree of control over the distraction process once the springs have been implanted. The use of springs does require stringent planning of the osteotomies and the type of force vectors (springs) used. Preoperative finite element modeling provides an excellent platform for planning these procedures as well as undertaking informed consent from the families. Patient selection remains key to good outcomes. In this chapter, we have elaborated on the above, utilizing our single institution experience of over 300 cases undertaken over the past decade.