Abstract: Hand operable pneumatically driven medical actuator and method of use preferably utilized for orthopedic or orthodontic manipulation in a user enabled pulse modulated mode. In one form, the medical actuator includes a free piston moveable within the body of the actuator responsive to pressurized gas selectively injected through a valve controlled by the hand supporting the actuator. The valve is operable in both pulse width and pulse frequency modulation modes, initiating corresponding pneumatic forces and acceleration effects on the free piston. A piston stop attached to a shaft extending from the medical actuator converts piston momentum into pulses of force transferable through the shaft to a translation device external to the medical actuator. The force pulses conveyer to the orthopedic or orthodontic translation device act upon teeth, bones, implants, or the like. Pulse modulation in a single hand operating mode permits the user to impart precise dynamic forces to the thing being manipulated.