Amniotic band sequence: the use of bone grafting and distraction osteogenesis.
Distraction has proven to be a useful technique in cases of severe bone deficiency in the craniofacial skeleton. This is a report of its use in the treatment of a child affected by amniotic band sequence. This 5 year old Hispanic female presented with transverse deficiences of one lower extremity and both upper extremities. Additionally, she was missing the mandible and overlying soft tissue from ramus to ramus. Although free fibula transfer was a possibility, due to the presence of only one lower extremity, it was elected to utilize the technique of distraction. After preliminary bone grafting to unite these two hemimanibles, the bone graft was distracted bilaterally to create a neomandible. Following consolidation and removal of the distraction devices, the child was markedly improved despite what appeared to be a pathologic fracture in the region of the mandibular angle. Repeat distraction was planned.
Kim
John
J
Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas 77030, USA.
Hollier
Larry
L
Taylor
Terry
T
D000652:Amniotic Band Syndrome / Q000601:surgery*; D016025:Bone Transplantation; D002675:Child, Preschool; D019465:Craniofacial Abnormalities / Q000601:surgery*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008334:Mandible / Q000002:abnormalities* / Q000601:surgery*; D019647:Oral Surgical Procedures / Q000379:methods*; D019857:Osteogenesis, Distraction