Pulsed electromagnetic fields for the treatment of tibial delayed unions and nonunions. A prospective clinical study and review of the literature.
Pulsed electromagnetic fields for the treatment of tibial delayed unions and nonunions. A prospective clinical study and review of the literature.
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DOI：
10.1186/1749-799x-7-24
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发表时间：
2012-06-08
影响因子：
2.6
通讯作者：
Chalidis BE
中科院分区：
文献类型：
--
作者：
Assiotis A;Sachinis NP;Chalidis BE
脉冲电磁场(PEMF)刺激治疗骨不连或延迟愈合已经使用了几年，但基础有限。这项研究的目的是评估该方法在胫骨延迟愈合和骨不连中的总体疗效，并确定可能影响最终结果的因素。我们前瞻性地回顾了44名患者(27名男性)，平均年龄49.6 ± 18.4 ，因胫骨延迟愈合或骨不连而接受PEMF治疗。所有病例骨折间隙均小于1 cm，无感染及软组织缺损。骨折愈合34例(77.3%)。骨折愈合率与年龄(p = 0.819)、骨折侧(左侧或右侧)(p = 0.734)、骨折类型(单纯型或粉碎型、开放性或闭合型)(p = 0.111)、吸烟(p = 0.245)、糖尿病(p = 0.68)和最初的治疗方法(钢板、钉、石膏)(p = 0.395)无关。治疗开始时间对骨折愈合率无明显影响(p = 0.841)。虽然没有统计学意义，但治疗时间越长，愈合的可能性就越高(p = 0.081)。PEMF刺激是治疗非感染性胫骨愈合异常的一种有效的非侵入性方法。它的成功与特定的骨折或患者相关变量无关，也不能清楚地认为是一种依赖时间的现象。
Pulsed electromagnetic fields (PEMF) stimulation for the treatment of bone nonunion or delayed union have been in use for several years, but on a limited basis. The aim of this study was to assess the overall efficacy of the method in tibial delayed unions and nonunions and identify factors that could affect the final outcome. We prospectively reviewed 44 patients (27 men) with a mean age of 49.6 ± 18.4 years that received PEMF therapy due to tibial shaft delayed union or nonunion. In all cases, fracture gap was less than 1 cm and infection or soft tissue defects were absent. Fracture union was confirmed in 34 cases (77.3%). No relationship was found between union rate and age (p = 0.819), fracture side (left or right) (p = 0.734), fracture type (simple or comminuted, open or closed) (p = 0.111), smoking (p = 0.245), diabetes (p = 0.68) and initial treatment method applied (plates, nail, plaster of paris) (p = 0.395). The time of treatment onset didn’t affect the incidence of fracture healing (p = 0.841). Although statistical significance was not demonstrated, longer treatment duration showed a trend of increased probability of union (p = 0.081). PEMF stimulation is an effective non-invasive method for addressing non-infected tibial union abnormalities. Its success is not associated with specific fracture or patient related variables and it couldn’t be clearly considered a time-dependent phenomenon.