Skip to main content

Advertisement

SpringerLink
Log in

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

  • Original Article
  • Published:
Indian Journal of Orthopaedics Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Availability of Data and Material

All retrospective reviewed data and material are available into the software and archives of the Institute.

Code Availability

Not applicable.

References

  1. Cicciù, M., Stacchi, C., Fiorillo, L., Cervino, G., Troiano, G., Vercellotti, T., Herford, A. S., Galindo-Moreno, P., & Di Lenarda, R. (2021). Piezoelectric bone surgery for impacted lower third molar extraction compared with conventional rotary instruments: A systematic review, meta-analysis, and trial sequential analysis. International Journal of Oral and Maxillofacial Surgery, 50(1), 121–131. https://doi.org/10.1016/j.ijom.2020.03.008 Epub 2020 Apr 11 PMID: 32284166.

    Article  PubMed  Google Scholar 

  2. Agarwal, E., Masamatti, S., & Kumar, A. (2014). Escalating role of piezosurgery in dental therapeutics. J Clin Diagn Res, 8(10):ZE08–ZE11.

    PubMed  PubMed Central  Google Scholar 

  3. Schlee, M., Steigmann, M., Bratu, E., et al. (2006). Piezosurgery: Basics and possibilities. Implant Dentistry, 15(4), 334–340.

    Article  Google Scholar 

  4. Nalbandian, S. (2011). Piezosurgery techniques in implant dentistry. Aust Dent Pract, 22, 116–126.

    Google Scholar 

  5. Shakouri, E., & Abbasi, M. (2018). Investigation of cutting quality and surface roughness in abrasive water jet machining of bone. Proceedings of the Institution of Mechanical Engineers Part H, 232(9), 850–861.

    Article  Google Scholar 

  6. Hoigne, D. J., Stubinger, S., VonKaenel, O., et al. (2006). Piezoelectric osteotomy in hand surgery: First experience with new technique. BMC Musculoskeletal Disorders, 7, 36–39.

    Article  Google Scholar 

  7. Augustin, G., Zigman, T., Davila, S., et al. (2012). Cortical bone drilling and thermal steonecrosis. Clinical Biomechanics, 27, 313–325.

    Article  Google Scholar 

  8. Haide, T., Geisler, D., Thalhammer, G., et al. (2017). Multiple drill-hole osteotomy in hand surgery—description of a novel application and proof of feasibility. BMC Musculoskeletal Disorders, 18, 529–535.

    Article  Google Scholar 

  9. Marco, M., Millán, M. R., Santiuste, C., et al. (2015). A review on recent advances in numerical modelling of bone cutting. Journal of Mechanical Behaviour of Biomedical Materials, 44, 179–201.

    Article  Google Scholar 

  10. Acciaro, A. L., Garagnani, L., Lando, M., Lana, D., Sartini, S., & Adani, R. (2021). Modified dome osteotomy and anterior locking plate fixation for distal radius variant of Madelung deformity. Journal of Plastic Surgery and Hand Surgery. https://doi.org/10.1080/2000656X.2021.1934845 Epub ahead of print. PMID: 34106811.

    Article  Google Scholar 

  11. Teoh, L. C., Yong, F. C., & Chong, K. C. (2002). Condylar advancement osteotomy for correcting condylar malunion of the finger. Journal of Hand Surgery (Edinburgh, Scotland), 27(1), 31–35.

    Article  CAS  Google Scholar 

  12. Ammori, M. A., Elvey, M., Mahmoud, S. S., et al. (2019). The outcome of bone graft surgery for nonunion of fractures of the scaphoid. Journal of Hand Surgery, 44(7), 676–684.

    Article  Google Scholar 

  13. Leti Acciaro, A., Lana, D., Fagetti, A., et al. (2021). Plate fixation in challenging traumatic carpal scaphoid lesions. Musculoskeletal Surgery. https://doi.org/10.1007/s12306-020-00689-1

    Article  PubMed  PubMed Central  Google Scholar 

  14. De Santis, G., Pinelli, M., & Starnoni, M. (2021). Extended and unusual indications in jaw reconstruction with the fibula flap: An overview based on our 30-year experience. Annals of Medicine and Surgery, 62, 37–42.

    Article  Google Scholar 

  15. Davidson, S. R., & James, D. F. (2003). Drilling in bone: Modeling heat generation and temperature distribution. Journal of Biomechanical Engineering, 125(3), 305–314.

    Article  Google Scholar 

  16. Starnoni, M., Colzani, G., De Santis, G., et al. (2019). Median nerve injury caused by screw malpositioning in percutaneous scaphoid fracture fixation. Plastic and Reconstructive Surgery. Global Open, 7(6), e2292.

    Article  Google Scholar 

  17. Leti Acciaro, A., Pilla, F., Faldini, C., et al. (2018). The carpal tunnel syndrome in children. Muskoloskeletal Surgery, 102(3), 261–265.

    Article  CAS  Google Scholar 

  18. Leti Acciaro, A., Lando, M., Russomando, A., et al. (2018). A mini-invasive tenolysis of the flexor tendons following hand fractures: Case series. Musculoskeletal Surgery, 102(1), 41–45.

    CAS  PubMed  Google Scholar 

  19. Leti Acciaro, A., Pilla, F., Colzani, G., et al. (2018). A new sign allowing diagnosis in the pathologies of the extensor tendons of the hand. Injury, 49(6), 119–1125.

    Article  Google Scholar 

  20. Starnoni, M., Colzani, G., De Santis, G., et al. (2019). Management of locked volar radio-ulnar joint dislocation. Plastic and Reconstructive Surgery. Global Open, 7(10), e2480.

    Article  Google Scholar 

  21. Acciaro, A. L., Colzani, G., Starnoni, M., et al. (2021). The challenges in restoration of extensor tendns function at the hand. Acta Biomedica, 92(S1), e2021151.

    Google Scholar 

  22. Hoigne, D., Hug, U., & Von Wartburg, U. (2011). Piezoelectric osteotomy in hand surgery: The autologous osteocartilage transplantation for joint. Handchirurgie, Mikrochirurgie, Plastische Chirurgie, 43(5), 319–320.

    Article  CAS  Google Scholar 

  23. Ichihara, S., Vaiss, L., Acciaro, A. L., et al. (2015). External bone remodeling after injectable calcium-phosphate cement in benign bone tumor: Two case in the hand. Orthopaedics and Traumatology, Surgery and Research, 101(8), 983–986.

    Article  CAS  Google Scholar 

  24. Landi, A., Cavazza, S., Caserta, G., et al. (2003). The upper limb in cerebral palsy: Surgical management of shoulder and elbow deformities. Hand Clinics, 19(4), 631–648. https://doi.org/10.1016/s0749-0712(03)00062-3

    Article  CAS  PubMed  Google Scholar 

  25. Claire, S., Lea, S. C., & Walmsley, A. D. (2013). Characterization of bone following ultrasonic cutting. Clinical Oral Investigations, 17(3), 905–912.

    Article  Google Scholar 

  26. Vercellotti, T., Nevins, M. L., Kim, D. M., Nevins, M., Wada, K., Schenk, R. K., & Fiorellini, J. P. (2005). Osseous response following resective therapy with piezosurgery. The International Journal of Periodontics and Restorative Dentistry, 25(6), 543–549. PMID: 16353529.

    PubMed  Google Scholar 

  27. Battiston, B., Leti Acciaro, A., & De Leo, A. (2013). The role of the FESSH Hand Trauma Committee in Europe. Handchirurgie, Mikrochirurgie, Plastische Chirurgie, 45(6), 326–331.

    Article  CAS  Google Scholar 

  28. Leti Acciaro, A., Montanari, S., Venturelli, M., et al. (2021). Retrospective study in clinical governance and financing system impacts of the COVID-19 pandemic in the hand surgery and microsurgery HUB center. Musculoskeletal Surgery. https://doi.org/10.1007/s12306-021-00700-3

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

No funding or royalties were received to assist with the preparation of this manuscript.

Author information

Authors and Affiliations

  1. Hand Surgery and Microsurgery Department, AOU Policlinico of Modena, L.Go del Pozzo, 71, 41124, Modena, Italy

    Andrea Leti Acciaro, Mario Lando, Giuliano Giuca & Roberto Adani

  2. Clinic of Plastic and Reconstructive Surgery, AOU Policlinico of Modena, Modena, Italy

    Marta Starnoni

Authors
  1. Andrea Leti Acciaro
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mario Lando
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Marta Starnoni
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Giuliano Giuca
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Roberto Adani
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors directly contributed in the surgical and follow-up efforts.

Corresponding author

Correspondence to Andrea Leti Acciaro.

Ethics declarations

Conflict of Interest

All 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.

Ethical Approval

The article does not contain any trial with human participants or animals performed by any of the authors. The retrospective analysis of the human data was in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. No studies regarding human and/or animal rights were conducted in the study.

Informed Consent

Informed consent was obtained from all patients before surgery as well as for the collected data at the follow-up.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Leti Acciaro, A., Lando, M., Starnoni, M. et al. Piezoelectric Bone Surgery. Overview in Applications and Proof of Feasibility in Hand and Plastic Surgery. JOIO 56, 66–72 (2022). https://doi.org/10.1007/s43465-021-00454-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s43465-021-00454-x

Keywords

Search

Navigation