Operations to correct bone defects had been carried out from the earliest years of the 19th century with varying degrees of success. The risks involved, mainly suppuration of wounds, limited the practice to a few individuals but with the adoption of Lister's anti-septic methods those risks became considerably reduced and the field began to flourish. One of the first to carry out an antiseptic osteotomy and a pioneer in the field was William Macewen.

Initially a variety of instruments were used to carry out operations, with saws being the most popular. Macewen favoured the chisel, he did acknowledge a number of flaws that existed with chisels but believed these to be a result of the quality of instrument used. Most surgeons simply employed carpenter's chisels that were difficult to control and had tendency to bend or even break entirely, resulting in a number of patients deaths.

Macewen set out to design a range of instruments for the purpose of Osteotomy - chisels for the removal of bone and what were basically a kind of specialised chisel to accurately split or create wedges in bone, these specialised instruments he termed Osteotomes. He employed a local blacksmith to create his instruments and remarks in Osteotomy that 'Mr. Macdonald put himself to some trouble to carry out my instructions concerning the manufacture of these instruments and also in determining the exact temper necessary'. The temper was important, as the instrument had to be strong enough not to bend when used yet flexible enough not to break.

The instruments seen here were manufactured from Stubb's finst five-eights steel; they were first heated, then dipped in oil, then in water until cool and then the tip was heated again. This was to ensure that the cutting was sufficiently hard while the body was sufficiently flexible. The handle and blade are one piece and the handle has an octagonal shape to allow a firmer grip and better control. The round projection at the top is both to allow the user to steady the blade with his thumb and to enable it to be gently levered out. The steel has been finely polished to insure that no organic matter adheres to the instrument. The blade itself is bevelled on both sides and on one of the borders are inscribed half-inch measurements to allow the user to measure how deep the instrument has entered.