Bassett C A, Caulo N, Kort J
Clin Orthop Relat Res. 1981 Jan-Feb(154):136-48.
During the past seven years, 34 patients with infantile nonunions associated with congenital "pseudarthroses" completed treatment with pulsing electromagnetic fields (PEMFs). An analysis of results reveals that 17/34 (50%) have achieved complete healing with biomechanically sound union and radiographic demonstration of remedullarization. Union with function, i.e., healing with continued need for protection, was achieved in 7/34 (21%). Failure was the outcome in 10/34 patients (29%). Most of these occurred in males with a history of early fracture (less than 1 year) and with spindled, hypermobile lesions (Type III). During the early period of the study, PEMFs were the sole means of treatment. After a "coil effect" had been demonstrated, surgical realignment, immobilization and grafting were combined with PEMF treatment. Fundamentals of orthopedic management developed by the larger experience with adult nonunions were found to apply equally to infantile nonunions treated with PEMFs. These include effective immobilization of the fracture site and controlled "stress working" during recovery to facilitate gradual remodeling. PEMFs have been demonstrated to be a potentially useful adjunct in the orthopedic surgeon's armamentarium for treating infantile nonunions (congenital "pseudarthroses").
在过去七年中，34例与先天性“假关节”相关的小儿骨不连患者完成了脉冲电磁场（PEMF）治疗。结果分析显示，17/34（50%）实现了完全愈合，骨愈合具有良好的生物力学性能且影像学显示骨髓腔再通。7/34（21%）实现了功能愈合，即愈合后仍需持续保护。10/34例患者（29%）治疗失败。其中大多数发生在有早期骨折史（小于1年）且病变呈纺锤形、活动度大的男性患者（III型）。在研究早期，PEMF是唯一的治疗手段。在证实“线圈效应”后，手术复位、固定和植骨与PEMF治疗相结合。通过对成人骨不连的更多经验所形成的骨科治疗基本原则同样适用于接受PEMF治疗的小儿骨不连。这些原则包括有效固定骨折部位以及在恢复过程中进行可控的“应力作用”以促进逐渐重塑。PEMF已被证明是骨科医生治疗小儿骨不连（先天性“假关节”）的一种潜在有用的辅助手段。
