Osteotomes are among the oldest instruments in bone surgery, dating back to ancient times. They remain essential for all orthopaedic surgery, including maxillofacial, ENT, dental, joint, limb, and reconstructive procedures.
While they may look simple at first glance, osteotomes are specialised in design, with a wide range of shapes and sizes, suited to different anatomical challenges and surgical outcomes.
This guide breaks down the main types of osteotomes, how they work, and where they’re commonly used.
What Is an Osteotome?
An osteotome is a manual bone-cutting instrument used to cut, shape, or remove bone. The tips can be single-bevelled, double-bevelled, straight or curved. The surgeon selects a specific design to enable precise, centralised cuts. They are typically used with a mallet, giving the surgeon tactile control as they advance through bone.
Osteotomes are manufactured in many lengths, weights, widths, blade angles, and profiles to match each clinical application, from delicate nasal osteotomies to large orthopaedic procedures such as hip replacements.
1. Straight Osteotomes
Straight osteotomes feature a flat, linear blade and are among the most frequently used types.
Characteristics
- Straight shaft and cutting edge
- Available in narrow to very wide blade widths (2.0mm - 32.0mm)
- Strong, durable construction
Common Uses
- General orthopaedic bone cutting
- Harvesting or shaping bone grafts
- Preparing bone surfaces during joint surgery
- Removing bone spurs or osteophytes
Straight osteotomes are often selected when the surgical field offers good visibility and a direct approach to the bone.
- Curved Osteotomes
Curved osteotomes are designed to follow natural anatomical contours or navigate confined spaces.
Characteristics
- Gentle or pronounced curvature
- Available in forward, reverse, or concave profiles
- Provide better access around corners or irregular bone surfaces
Common Uses
- Maxillofacial and craniofacial procedures
- Spine surgery, particularly around delicate structures
- Reshaping bones that have complex geometry
Curved osteotomes allow surgeons to apply controlled force without compromising surrounding tissues.
- Tapered and Narrow Osteotomes
These fine instruments feature slender, narrow blades that allow precision work in delicate areas.
Characteristics
- Thin, tapered cutting edge
- High control for small cuts
- Often available in graduated sizes
Common Uses
- Dental implant site preparation
- Sinus lift procedures
- Facial bone contouring
- Micro-osteotomies in restricted spaces
In implant dentistry, for example, tapered osteotomes help expand or condense bone while preserving bone density.
- Power Osteotomes
Although traditional osteotomes are manual, many modern surgical fields also use power-driven osteotomes. These are especially helpful when precision and speed are equally important.
Characteristics
- Powered pneumatically or electrically, with oscillating, ultrasonic or rotary action
- Reduce surgeon fatigue
- Provide consistent cutting action
Common Uses
- High-volume orthopaedic cases
- Situations requiring rapid bone removal
- Osteotomies in very dense bone
- Named/Specialised Osteotomes
Many osteotomes are named after the surgeons who designed them, each with unique functional features.
Common Types
- Lambotte: Straight or curved, very common, used for general bone cutting. Designed by Dr Albin Lambotte (1866–1955), a Belgian orthopaedic surgeon and pioneer of internal fixation of fractures. Dr Lambotte developed many modern orthopaedic instruments.
- Hoke: Small in size, straight or curved, widely used for delicate surgery such as feet and ankle, and some spinal. Dr Michael Hoke (1874-1944) was an American surgeon. Specializing in foot and ankle surgery, he is considered one of the founders of modern reconstructive foot surgery
- Smith-Petersen: Robust, heavy design suited for reshaping during reconstructive surgery of larger bone surgery. Dr Marius Smith-Petersen (1886-1953) was an innovative Norwegian-American surgeon, with a key interest in hip surgery.
- Lexer: available in multiple widths, for both broader cuts and more detailed applications such as rhinoplasty and nasal fracture repair. Dr Erich Lexer (1867-1937) was a German surgeon. He initially trained and worked as a general and orthopaedic surgeon, but later became a pioneer in reconstructive and plastic surgery
These specialised tools provide options for surgeons working in highly specific anatomical spaces.
Dr Albin Lambotte Dr Michael Hoke Dr Marius Smith-Petersen Dr Erich Lexer
References:
https://fr.wikipedia.org/wiki/Albin_Lambotte#/media/Fichier:Albin_Lambotte._Photomechanical_print._Wellcome_V0028149.jpg
https://books.google.co.nz/books?id=5v12IKsI-M4C&pg=PA144&redir_esc=y#v=onepage&q&f=false
https://litfl.com/marius-nygaard-smith-petersen/
https://commons.wikimedia.org/w/index.php?curid=19026480
Surgical Applications Across Specialties:
Orthopaedics
- Corrective osteotomies
- Joint replacement preparation
- Bone reshaping and contouring
- Osteophyte removal
Spine Surgery
- Decompressions
- Facet joint reshaping
- Removal of bony overgrowth
Maxillofacial / Craniofacial
- Orbital, nasal, and mid-face osteotomies
- Corrective jaw surgery
- Access procedures for reconstructive cases
Dentistry and Implantology
- Sinus elevation
- Ridge expansion
- Bone condensation
- Precise implant site preparation
ENT Surgery
- Nasal bone repositioning
- Septorhinoplasty osteotomies
Why Surgeons Choose Osteotomes
Even with the rise of powered instrumentation, manual osteotomes remain vital because they offer:
- Tactile feedback - surgeons feel changes in bone density or resistance.
- Controlled force - precision is enhanced, particularly in delicate fields.
- Bone preservation - Osteotomes can displace bone rather than remove it, especially useful in dentistry and maxillofacial surgery.
- Versatility - with countless styles and sizes, there’s an osteotome for nearly every type of bone work.
Accompanying the use of Osteotomes, is the use of the surgical Mallet. Surgical Mallets are likewise available is a wide selection of sizes and weights and are carefully matched to the surgical application being performed.
Please reach out if you would like further information on any osteotomes in our range. Our full suite of options can be viewed in our Orthopaedic Catalogue from pages 74-94. You can view this on the link below:
https://www.hallmarksurgical.com/wp-content/uploads/2022/09/Reusable-Ortho-Neuro-Micro-Instrument-Catalogue.pdf
