Role of PEMF in fracture healing

Pulsed Electromagnetic Field Stimulation After Tibial Shaft Fractures-Journal Club

J Bone Joint Surg Am.  2011;93(17):1569-1576  doi:10.2106/jbjs.j.00869

Sam Adie, Ian harris, Justine Naylor, Hamish Rae, Alan Dao, Sara Yong, Victoria Ying

• 259 patients with Acute tibial shaft fractures were randomised to receive externally active pulsed electromagnetic field stimulation or placebo in which the device was inactive
• Intervention: Adjuvant PEMF therapy consists of a coil that is strapped to the leg. The field is generated 90 degrees to the tibial shaft
• Control: Placebo device used ,but was inactive
• Outcomes: Rate of secondary surgery, surgical revision to promote union, surgical revision for any indication, radiographic union, functional outcomes(using 80 point Lower extremity functional scales), health status(using Physical Component summary score of Sh)
• Methods: RCT, Orthopaedic Department, Liverpool Hospital, Liverpool, Australia
• Important findings in the study: 16 patients in the active treatment group and 15 patients in the placebo group had secondary surgery for delayed union or nonunion. The difference was not statistically significant
• The results of 12 month follow up period indicated that there was no difference in regards to secondary surgery due to delayed union or nonunion
• This trial although could not demonstrate superior results of PEMF, larger clinical trials are needed to establish the role of PEMF in fracture healing
• In Conclusion, PEMF doesnot lead to lower surgical revision rates compared to placebo
• The study is industry funded by Biomet, Australia.