This paper is a review of the literature regarding the effects of electromagnetic fields (EMFs) on non-healing of bone fractures. The current information supports the use of EMFs to reduce disability resulting from non-union of fractures, but the literature on this subject is limited. This review included 51 articles on the use of EMFs on bone healing.
Non-union of fractures, failure of the two ends to heal, is a problem in 20% of fractures, especially of the tibial bones of the legs. There are various techniques to increase healing, including electrical and electromagnetic stimulation. Bone grafting is the standard, but is successful in only a small fraction of the cases. EMFs stimulation has the advantage of being noninvasive, has been practiced for decades, and there seem to be no negative effects in clinical studies.
Low frequency EMFs may stimulate bone tissue to rebuild itself. It is useful in osteoporosis, tendonitis, fractures, and non-union of fractures. Success depends on the parameters of the fields applied. Some of the effects are increased gene expression of collagen type II, increased VEGF, and an anti-inflammatory effect. Low-frequency EMF (5 mT, 20 Hz) reduced Staphylococcus aureus infection by 32% within 24 hours. More studies are needed on the anti-infection activity of EMFs, as well as the intensity, frequency, impulse, and amplitude to be used in clinical treatments.
Serum calcium was increased in animals exposed to 0.2 mT, 50 Hz for 8 hours per day for 30 days. Calcium was released from the bone, resulting in bone weakness, potentially causing osteoporosis.
CONCLUSION: EMF therapy is useful in treatment on non-healing fractures. However further research is needed.
NOTE: There are two measures of magnetic flux density. Tesla (T) is the measure in meter-kg-seconds. Gauss (G) is the measure in centimeters-grams-seconds.
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