Twenty-one people have been convicted for their parts in the largest ever child sex abuse case investigated by West Midlands Police.
The offending against seven children, who were 12 years old or younger, took place over nearly a decade in Walsall and Wolverhampton.
The abuse came to light after concerns were raised following a hospital visit by one of the victims.
Thirteen of the defendants have been jailed with four to be sentenced later.
The offences against the children were "some of the most shocking abuse that I've seen in my career", Det Ch Supt Paul Drover said.
"They have been through a significant amounts of trauma. To get the confidence to come forward and to talk to care professionals, to police is huge and I am genuinely thankful," he added.