Implantable direct-current bone stimulators in high-risk and revision foot and ankle surgery: a retrospective analysis with outcome assessment.
Efficacy and morbidity of a surgically implanted direct-current bone stimulator were evaluated in 38 patients (40 feet) with fracture nonunion or at high risk for nonunion; 14 of these patients had Charcot (diabetic) neuroarthropathy. Union occurred in 26 (65%) of the 40 feet; complications other than nonunion occurred in 16 feet (40%). Two amputations (5%) were performed in cases of intractable neuritis and deep infection. Of the 6 cases of deep infection (15%), 5 resolved with device removal, and the sixth case required below-knee amputation. Use of a bone stimulator in patients with diabetes may be problematic, but the device did not have any adverse effects in other high-risk patients.
Lau
Johnny T C
JT
Department of Orthopaedic Surgery, Union Memorial Hospital, Baltimore, Maryland, USA.
Stamatis
Emmanouil D
ED
Myerson
Mark S
MS
Schon
Lew C
LC
D000328:Adult; D000368:Aged; D016512:Ankle Injuries / Q000601:surgery*; D001174:Arthrodesis; D004599:Electric Stimulation Therapy / Q000009:adverse effects; D004567:Electrodes, Implanted; D005260:Female; D018409:Foot Injuries / Q000601:surgery*; D017102:Fracture Healing; D005599:Fractures, Ununited / Q000150:complications / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy; D012086:Reoperation; D012307:Risk Factors