Department of Orthopaedics, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No, 321 Zhongshan Road, Nanjing, China.
BMC Musculoskelet Disord. 2013 Jan 19;14:35. doi: 10.1186/1471-2474-14-35.
Pulsed electromagnetic field (PEMF) is reported to be an effective adjunct for the management of nonunion long-bone fractures. Most studies implement PEMF treatment after 6 months or longer of delayed union or nonunion following fracture treatment. Despite these variations in treatment, the early application of PEMF following a diagnosis of a postoperative delayed union has not been specifically analyzed. In this study, the outcomes of postoperative delayed union of long-bone fractures treated with an early application of PEMF were evaluated as compared with a sham-treated control group.
In this prospective, randomized controlled study, a total of 58 long-bone fracture patients, who presented with delayed union of between 16 weeks and 6 months, were randomly split into two groups and subjected to an early application of PEMF or sham treatment. Clinical and radiological assessments were performed to evaluate the healing status. Treatment efficacy was assessed at three month intervals.
Patients in the PEMF group showed a higher rate of union than those in the control group after the first three months of treatment, but this difference failed to achieve statistical significance. At the end of the study, PEMF treatment conducted for an average of 4.8 months led to a success rate of 77.4%. This was significantly higher than the control, which had an average duration of 4.4 months and a success rate of 48.1%. The total time from operation to the end of the study was a mean of 9.6 months for patients in the PEMF group.
Fracture patients treated with an early application of PEMF achieved a significantly increased rate of union and an overall reduced suffering time compared with patients that receive PEMF after the 6 months or more of delayed union, as described by others.
脉冲电磁场（PEMF）被报道为治疗长骨骨折不愈合的有效辅助手段。大多数研究在骨折治疗后 6 个月或更长时间出现延迟愈合或不愈合后才开始实施 PEMF 治疗。尽管治疗方法存在差异，但在术后延迟愈合诊断后早期应用 PEMF 尚未得到专门分析。在这项研究中，我们评估了与假治疗对照组相比，早期应用 PEMF 治疗长骨骨折术后延迟愈合的结果。
在这项前瞻性、随机对照研究中，共有 58 例长骨骨折患者，其延迟愈合时间在 16 周至 6 个月之间，他们被随机分为两组，分别接受早期 PEMF 应用或假治疗。通过临床和影像学评估来评估愈合情况。每隔三个月评估一次治疗效果。
在治疗的前三个月，PEMF 组患者的愈合率高于对照组，但差异无统计学意义。在研究结束时，PEMF 治疗平均进行 4.8 个月后，成功率为 77.4%。这显著高于对照组的 48.1%，对照组的平均治疗时间为 4.4 个月。PEMF 组患者从手术到研究结束的总时间平均为 9.6 个月。
与其他研究中描述的在延迟愈合 6 个月或更长时间后才接受 PEMF 治疗的患者相比，早期应用 PEMF 治疗的骨折患者的愈合率显著提高，总痛苦时间也明显缩短。
