A review of bone growth stimulation for fracture treatment

Delay or failure of fracture healing is a common, significant clinical problem confronting orthopaedic surgeons. Treatment options consist of invasive surgical techniques, such as internal and external fixation, bone grafting, and more radically, amputation. Noninvasive options include bone growth stimulation. A PubMed search was performed for basic science and clinical articles regarding bone growth stimulation in the English language. Articles were assessed for study design, size, validity (with previously published literature), technology utilized, and method of treatment. The search identified articles from 1957 to present. These articles were reviewed, and ten additional references (i.e. book chapters) were analyzed as well. Meta-analysis of the data on bone growth stimulators for delayed and nonunion of fractures is difficult because of the heterogeneity of various trials and device specifications. Large, randomized, placebo-controlled trials are lacking, and much of the data reflect larger case series and comparative studies. Nevertheless, basic science and clinical evidence support the efficacy of bone growth stimulation as a fracture healing modality in the appropriate clinical situation.