Early application of pulsed electromagnetic field in the treatment of postoperative delayed union of long-bone fractures: a prospective randomized controlled study

Abstract

BackgroundPulsed electromagnetic field (PEMF) is reported to be an effective adjunct for the management of nonunion long-bone fractures. Most studies implement PEMF treatment after 6 months or longer of delayed union or nonunion following fracture treatment. Despite these variations in treatment, the early application of PEMF following a diagnosis of a postoperative delayed union has not been specifically analyzed. In this study, the outcomes of postoperative delayed union of long-bone fractures treated with an early application of PEMF were evaluated as compared with a sham-treated control group.MethodsIn this prospective, randomized controlled study, a total of 58 long-bone fracture patients, who presented with delayed union of between 16 weeks and 6 months, were randomly split into two groups and subjected to an early application of PEMF or sham treatment. Clinical and radiological assessments were performed to evaluate the healing status. Treatment efficacy was assessed at three month intervals.ResultsPatients in the PEMF group showed a higher rate of union than those in the control group after the first three months of treatment, but this difference failed to achieve statistical significance. At the end of the study, PEMF treatment conducted for an average of 4.8 months led to a success rate of 77.4%. This was significantly higher than the control, which had an average duration of 4.4 months and a success rate of 48.1%. The total time from operation to the end of the study was a mean of 9.6 months for patients in the PEMF group.ConclusionsFracture patients treated with an early application of PEMF achieved a significantly increased rate of union and an overall reduced suffering time compared with patients that receive PEMF after the 6 months or more of delayed union, as described by others.

Low-intensity pulsed ultrasonography versus electrical stimulation for fracture healing: a systematic review and network meta-analysis

“…Adie et al 43 Barker et al 44 Beck et al 45 Betti et al 46 Borsalino et al 47 Emami et al 32 Eyres et al 48 Faldini et al 49 Handolin et al 33 Handolin et al 34 Hanneman et al 20 Heckman et al 35 Kristiansen et al 36 Leung et al 37 Lubbert et al 38 Mammi et al 50 Mayr et al 39 Poli et al 51 Ricardo 22 Rue et al 40 Scott et al 52 Sharrard 53 Shi et al 31 Simonis et al 54 Strauss et al 41 Wahlström 55 Yadav et al …”

“…We also knew of 2 recent trials that were published after our updated search. 20,31 Thus, 27 trials were included in our review: 12 evaluating LIPUS [32][33][34][35][36][37][38][39][40][41][42] and 15 evaluating ESTIM. 20,31,[43][44][45][46][47][48][49][50][51][52][53][54][55] There was perfect agreement between reviewers in the full text review stage.…”

A Minimally Invasive Surgery for Bone Metastases Using the Combination of Photodynamic Therapy and Hyperthermia Treatment

“…Radiation therapy inhibits bone formation, due to the death of osteoblasts. On the other hand, hyperthermia by EMHT kills the tumor cells, EMHT can repeatedly be performed without increased complications (unlike conventional radiation therapy), and EMHT has the potential to promote bone formation by electronic stimulation [30][31][32][33]. We previously reported the efficacy of hyperthermia treatment for bone metastasis compared with the surgical treatment in combination with or without radiotherapy [23].…”

Desain Dan Pembuatan Prototipe Pulse Electromagnetic Therapy (Pemft) Untuk Studi Bioelektromagnetik

“…Diakhir pengobatan, berdasarkan penilaian radiologi diperoleh grup EMF menunjukkan laju penyembuhan sebesar 77.4 % sedangkan pada kontrol sebesar 48.1 % dengan waktu rata -rata total dari pertama penyembuhan sebelum diagnosa delayed union, grup EMF selama 9.6 bulan dan grup kontrol 9.5 bulan [3].…”