Division of Orthopaedics, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
J Orthop Trauma. 2010 Mar;24 Suppl 1:S62-5. doi: 10.1097/BOT.0b013e3181cdde1b.
This article provides an overview of the biology behind the use of electrical stimulation in fracture healing and discusses the current methods of electrical bone growth stimulation. In addition, we review the best available clinical evidence for the use of electrical stimulation in the treatment of delayed and nonunions of fractures. Our search identified 4 meta-analyses on the use of electrical stimulation on fracture healing. The most methodologically rigorous and recent meta-analysis suggests that the current evidence is insufficient to conclude a benefit of electromagnetic stimulation in improving the rate of union in patients with a fresh fracture, osteotomy, delayed union, or nonunion. The other 3 meta-analyses that we identified suggested a more significant treatment effect from electrical stimulation. Although the evidence supporting electrical stimulation does trend in favor of its use to help achieve bony union, further large, multicenter, randomized, controlled trials are required to resolve the current uncertainty surrounding the use of electrical stimulation and fracture healing.
本文概述了电刺激在骨折愈合中的生物学原理,并讨论了目前电刺激促进骨生长的方法。此外,我们还回顾了电刺激治疗骨折延迟愈合和不愈合的最佳临床证据。我们的检索共确定了 4 项关于电刺激促进骨折愈合的荟萃分析。最具严谨性和最新的荟萃分析表明,目前的证据不足以得出电磁刺激在提高新鲜骨折、截骨术、延迟愈合或不愈合患者愈合率方面有益的结论。我们发现的其他 3 项荟萃分析则表明电刺激的治疗效果更为显著。虽然支持电刺激的证据确实倾向于表明其可用于帮助实现骨愈合,但仍需要进行更多大型、多中心、随机、对照试验,以解决当前围绕电刺激和骨折愈合应用的不确定性。