Electromagnetic stimulation in treating nonunion or delayed union of long bone fractures : a meta analysis

Objective To collect and analyze the literature on electromagnetic field stimulation in the treatment of nonunion or delayed union of long bone fractures,and to evaluate its efficacy and safety.Methods Research on electromagnetic stimulation indexed by Medline,Embase and other databases including unpublished literature was collected using pre-established inclusion and exclusion criteria.Comparative studies reporting on the outcomes of electromagnetic field stimulation for the treatment of long bone fractures were the focus.Data were extracted for outcomes including total union rate,nonunion rate,adverse events,and visual analogue scale (VAS) ratings of pain.The quality of each reference was assessed.Where feasible,meta-analyses were performed using RevMan 5.1 software.Results A total of 4 papers reporting 4 randomized controlled trials were found.They reported on 58 patients treated with electromagnetic field stimulation and 63 in sham stimulation groups.There was no significant difference in total union rate after treatment for 12 weeks,or in the nonunion rate after treatment for 24 weeks.VAS scale ratings were also not significantly different in the two groups.Conclusions Electromagnetic field stimulation may be an effective and safe therapy to treat nonunion or delayed union of long bone fractures,but there is not yet adequate evidence to determine its real efficiency and safety.Large,well designed and multi-centre randomized and controlled clinical trials are needed. Key words: Fracture healing; Bone stems; Electric stimulation therapy; Electro-magnetic fields