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The purpose of this study was to evaluate human mandibular lengthening by gradual distraction. The operation was performed under nasoendotracheal anesthesia. After exposing the angle of the mandible through an intraoral incision, two half-pins were inserted on each side of the corticotomy line. Following this, a corticotomy was performed using a sagittal saw, and the mandible was gently fractured. The external bone lengthening device was applied leaving a bone gap of 3 mm. Serial distraction of 1 mm per day was started on the 10th postoperative day. The device was left in place for retention purposes for 9–11 weeks. Three patients (average age 10 years and 3 months) underwent this procedure. The distraction achieved was 19 mm. Postoperatively, improvement of facial asymmetry and increased volume and length of the mandible were noted without any perioperative complications. The follow-up period averaged 13 months. These results suggested that this procedure is beneficial for the treatment of craniofacial microsomia.

Distally based radial and ulnar forearm flaps were employed to reconstruct iatrogenic dorsal skin defects of hands in young children. The defects resulted from the extravasation of intravenous medication; flaps were required for reconstruction because the extensor tendons were exposed in the base of the ulcer in Case 1 and were involved in dense scar tissue in Case 2. The reverse forearm flap is an easy and reliable technique requiring short operating time, and it allows initiation of early physiotherapy compared with the other techniques, such as free flap or an abdominal flap.