A Review of Bone Growth Stimulation for Fracture Treatment

Steve B. Behrens; Matthew E. Deren; Keith O. Monchik

Disclosures

Curr Orthop Pract. 2013;24(1):84-91. 

In This Article

Capacitive Coupling (CC)

Several Level II studies exist on the use of CC for treatment of delayed or nonunions, allowing for Grade B recommendation for its use. Brighton and Pollack[34] reported 77.3% successful fracture union by CC in 22 nonunions treated for an average of 22.5 weeks, with no effect on infection, previous recalcitrant nonunion, or prior internal fixation hardware. A prospective, double-blinded trial of established long-bone nonunion in 21 patients compared CC with placebo stimulation devices.[60] The successful union of 60% of fractures treated with CC was statistically significant compared with none of the placebo fractures achieving union, although the study was small in size and had a lower success rate compared with other studies.

A case series of 22 nonunions with a 0.5 cm or larger fracture gap demonstrated 72.7% fracture union after an average of 26 weeks of CC stimulation. Higher success rates were found in metaphyseal rather than diaphyseal fractures.[61] Benazzo et al.[76] reported the results of a open study on the treatment of stress fractures in athletes by CC. Twenty-five lower limb stress fractures in 21 athletes were treated with a median stimulation time of 52 days. Twentytwo fractures healed, one did not heal, and two improved. The paper illustrated that CC could be safely used in athletes with stress fractures.

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