title: Use of physical forces in bone healing.
abstract: During the past two decades, a number of physical modalities have been approved for the management of nonunions and delayed unions. Implantable direct current stimulation is effective in managing established nonunions of the extremities and as an adjuvant in achieving spinal fusion. Pulsed electromagnetic fields and capacitive coupling induce fields through the soft tissue, resulting in low-magnitude voltage and currents at the fracture site. Pulsed electromagnetic fields may be as effective as surgery in managing extremity nonunions. Capacitive coupling appears to be effective both in extremity nonunions and lumbar fusions. Low-intensity ultrasound has been used to speed normal fracture healing and manage delayed unions. It has recently been approved for the management of nonunions. Despite the different mechanisms for stimulating bone healing, all signals result in increased intracellular calcium, thereby leading to bone formation.
authors.affiliation: Henry Ford Hospital, Detroit, MI, USA.
authors.forename: Fred R T
authors.initials: FR
authors.lastname: Nelson
authors.forename: Carl T
authors.initials: CT
authors.lastname: Brighton
authors.forename: James
authors.initials: J
authors.lastname: Ryaby
authors.forename: Bruce J
authors.initials: BJ
authors.lastname: Simon
authors.forename: Jason H
authors.initials: JH
authors.lastname: Nielson
authors.forename: Dean G
authors.initials: DG
authors.lastname: Lorich
authors.forename: Mark
authors.initials: M
authors.lastname: Bolander
authors.forename: John
authors.initials: J
authors.lastname: Seelig
mesh_terms: D001842:Bone and Bones / Q000502:physiology*; D004599:Electric Stimulation Therapy; D004574:Electromagnetic Fields; D017102:Fracture Healing; D005599:Fractures, Ununited / Q000628:therapy*; D006801:Humans; D013123:Spinal Fusion; D014464:Ultrasonic Therapy; D014945:Wound Healing