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

Comparing Technologies

Few direct comparison studies exist to elucidate which technology to use in different clinical settings. Zorlu et al.[76] published a study of the effect of low-intensity ultrasound and percutaneous direct current for healing in rat fibular osteotomies. Both treatments improved healing, but there was no statistical significance between the two methods. Brighton et al.,[99] in 1995, published a retrospective study on tibial nonunions treated with a DC, CC, or bone graft in a retrospective study of 271 tibial nonunions treated over 24 years.[71,99] The average duration of the nonunion was 23.5 months, ranging from 9–69 months. Seven risk factors were identified, and as more risk factors were present, the healing rate decreased regardless of treatments. In cases of previous bone graft failure, repeat grafting was also less likely to be successful with electrical treatment. In atrophic nonunions, CC treatment had a worse healing rate than grafting or DC treatment.

Gossling et al.[71] compared surgery and PEMF in the treatment of nonunited tibial fractures.[71] They reviewed 42 articles, 14 using surgical treatment and 28 using PEMF. The overall treatment success rate from surgery was 82% in 258 tibias, while the overall treatment success rate for PEMF was 81% in 143 tibias. The success rate for nonunion surgery, therefore, drops dramatically with the successive number of operations, while it does not seem to affect the results of PEMF treatment.

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