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. 2021 Jul 9;56(1):66-72.
doi: 10.1007/s43465-021-00454-x. eCollection 2022 Jan.

Piezoelectric Bone Surgery. Overview in Applications and Proof of Feasibility in Hand and Plastic Surgery

Affiliations

Piezoelectric Bone Surgery. Overview in Applications and Proof of Feasibility in Hand and Plastic Surgery

Andrea Leti Acciaro et al. Indian J Orthop. .

Abstract

Purpose: Piezoelectric bone surgery was already extensively used in a number of surgical procedures ranging from dental to maxillofacial surgery. The authors aimed to determine whether piezosurgery was suitable and advantageous for performing osteotomies in Hand and Plastic reconstructive surgery.

Methods: The authors overviewed a variety of applications for Piezosurgery® Device, from Mectron, in bone reconstructive surgery with over the last 8 years. An overall number of 156 bone cutting procedures in adults and children was described at the phalanges, metacarpal bones and distal radius level, as well as in bone graft harvesting and bone remodeling following carpal scaphoid nonunion, scapho-lunate bone-ligament-bone reconstruction and fibula free flap in maxillofacial defects.

Results: The consolidation rate was 87.5% in scaphoid nonunion grafting and fixation. Bone healing was achieved in all other cases. No intra-operative complications were recorded.

Conclusion: Piezosurgery® allowed high precision in bone cutting as well as custom-made graft and surface roughness were obtained, while preserving nerves, vessels and tendons integrity. The instrument may be handling moved into the surgical space in absence of vibrations, with a clear view onto the bone. The mechanical and biological characteristics of the piezoelectrical effect perfected this technique as an effective and useful instrument in Hand and Plastic surgery. The selective bone cutting properties avoided injuries to the surrounding soft tissues and thermal damage of the bony cells. Best advantages were described in feasibility and flexibility for intra-articular osteotomies, custom-made grafts and reconstructive microsurgical techniques.

Keywords: Bone graft; Bone surgery; Hand surgery; Osteotomy; Piezoelectric; Plastic surgery.

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Conflict of interest statement

Conflict of InterestAll the authors declare they have no financial interests, no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangement, etc.) that might pose a conflict of interest in connection with the submitted article.

Figures

Fig. 1
Fig. 1
Intra-operative features of the Piezoelectric dome osteotomy in Madelung deformity correction. Radiographic follow-up of volar plate fixation
Fig. 2
Fig. 2
Particular of the piezoelectric bone graft harvesting from donor amputated digit, remodeled according to the bone loss of the survival digit
Fig. 3
Fig. 3
Operative features of the implantation and reconstruction of the phalangeal and articular bone loss. Radiographs showed the bone union and osteointegration at the follow-up
Fig. 4
Fig. 4
Intra-operative features of the double bone grafts harvested by piezosurgery. Axial bone graft to fill the cavitation following screw removal. Transverse wedge cortical bone graft to correct and fill the bone loss of the nonunion, and particular of the bone scalloping to envelope the other graft

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