Pulsed electromagnetic fields for the treatment of tibial delayed unions and nonunions. A prospective clinical study and review of the literature

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.