Electrical Stimulation

Introduction

Delayed unions and non-unions of long bone fractures are common complications encountered in orthopaedic medicine. Five to ten percent (300,000 to 600,000) of the 6 million fractures occurring annually in the United States develop some form of compromised union, amounting to an estimated economic loss of $3 to $6 billion annually. Electrical stimulation modalities have been employed for decades to promote the healing of delayed unions and non-unions.

Bone Growth Stimulation

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Regarding bone healing, a concept known as Wolff's Law states that "bone adapts its structure to mechanical loading conditions." In other words, how bone heals is based on the position and amount of stress put upon it. Scientists in the 1950's determined that electrical current can also affect bone healing.

Stress applied to bone causes the concave side to become electronegative and the convex side becomes electropositive. The correct amount and type of energy applied to healing bone improves the osteogenic or bone healing environment and stimulates calcification and mineralization of the repair.

All bone growth stimulators use an external power source, either with rechargeable or replaceable batteries. Patient compliance with the treatment regimen is important. The longer the patient uses the device each day, the greater the chance of reducing or avoiding a nonunion.

Direct Current (DC) Stimulation

DC stimulation uses implanted wires, placed at the time of surgery to repair a fracture or other condition. Treatment may last up to 6 months.

DC stimulators involve enhancing the expression of bone morphogenetic protein (BMP) and other bone growth factors, to "jumpstart" the bone healing process.

DC Stimulation video (for long bones)

DC Stimulation video (for spine)

Capacitive Coupling (CC) Stimulation

Capacitive Coupling stimulation technology involves the use of two electrodes applied to the skin at the site of healing. Alternating current from the electrodes creates a beneficial process to boost the course of healing the bones.

CC Stimulation video (for long bones)

CC Stimulation video (for spine)

Pulsed Electromagnetic Field Stimulation (PEMF)

PEMF uses external coils placed over the skin at the point of injury that emit electromagnetic waves or signals, to modulate bone healing, mimicking Wolff's Law.

When any one of these three primary methods of electrical bone growth stimulation has provided a favorable environment, the normal bone healing process can begin.

PEMF video

Combined Magnetic Field Stimulation (CMF)

CMF uses a combination of direct and alternating current to create magnetic fields. These units have external electrodes placed over the skin near the site of healing.