Electrical and Biomedical Engineering, School of Engineering, RMIT University, Melbourne, VIC, 3000, Australia.
St Vincent's Department of Surgery, The University of Melbourne, Fitzroy, VIC, 3065, Australia.
Ann Biomed Eng. 2018 Apr;46(4):525-542. doi: 10.1007/s10439-018-1982-1. Epub 2018 Jan 22.
Bone fractures are one of the most commonly occurring injuries of the musculoskeletal system. A highly complex physiological process, fracture healing has been studied extensively. Data from in vivo, in vitro and clinical studies, have shown pulsed electromagnetic fields (PEMFs) to be highly influential in the fracture repair process. Whilst the underlying mechanisms acting to either inhibit or advance the physiological processes are yet to be defined conclusively, several non-invasive point of use devices have been developed for the clinical treatment of fractures. With the complexity of the repair process, involving many components acting at different time steps, it has been a challenge to determine which PEMF exposure parameters (i.e., frequency of field, intensity of field and dose) will produce the most optimal repair. In addition, the development of an evidence-backed device comes with challenges of its own, with many elements (including process of exposure, construct materials and tissue densities) being highly influential to the field exposed. The objective of this review is to provide a broad recount of the applications of PEMFs in bone fracture repair and to then demonstrate what is further required for enhanced therapeutic outcomes.
骨折是肌肉骨骼系统最常见的损伤之一。骨折愈合是一个高度复杂的生理过程,已经进行了广泛的研究。来自体内、体外和临床研究的数据表明,脉冲电磁场(PEMFs)对骨折修复过程有很大的影响。虽然作用于抑制或促进生理过程的潜在机制尚未得到明确界定,但已经开发出几种用于临床治疗骨折的非侵入性即用型设备。由于修复过程非常复杂,涉及许多在不同时间点起作用的成分,因此很难确定哪种 PEMF 暴露参数(即场的频率、场的强度和剂量)会产生最佳修复效果。此外,开发有证据支持的设备本身也具有挑战性,许多因素(包括暴露过程、结构材料和组织密度)对暴露的场有很大影响。本综述的目的是广泛描述 PEMFs 在骨骨折修复中的应用,然后展示为了获得更好的治疗效果还需要进一步做哪些工作。
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