Constant direct-current treatment for established nonunion of the tibia.

The treatment of nonunion of the tibia in 40 patients by constant direct current was evaluated in a prospective survey. The method was simple to apply and the complication rate was low, but considerable cooperation is required on the part of patients. The success rate was 85%. When two patients who had significant fracture gaps and the one patient who had an undetected synovial pseudarthrosis were excluded, the corrected, realistic success rate was 92.5%. The results are equal to or better than those obtained by bone grafting; the method eliminates the complications of open bone operations. Although the precise biophysical mechanisms actively involved in this nonunion therapy are not to date fully comprehended, it is clear that the technique has been safe and beneficial in the majority of cases.