A Review of Electromagnetic Field Based Treatments for Different Bone Fractures

Bone fractures are among the common disorders worldwide. The healing process of a fracture is a relatively long period. Furthermore, a significant portion of fractures become nonunions or delayed that increase the long healing process of fractures even more. These characteristics have provoked the researchers to develop new techniques for reducing the healing process of fresh bone fracture as well as alternative treatments for nonunions and delayed fractures. Electromagnetic fields (EMFs) have shown a promising potential for this purpose. Different techniques have been proposed as alternative or adjunctive treatments for bone fractures the most important of them are direct current, capacitive coupling, inductive coupling (pulsed EMF), static and combined magnetic fields. For each technique, different protocols have been proposed and the studies are under investigation to optimize the treatment protocol for each method. Characteristics of a bone fracture are important factors for choosing the appropriate EMF based technique and its protocols. The characteristics include bone fracture type including closed or open fracture, union or nonunions, delayed and fresh fractures as well as the fracture site and volume. There are few comprehensive comparative studies on different modalities to determine the appropriate technique for each bone fracture type. This study reviews and compares the current EMF based treatments for different bone fractures to propose appropriate treatment for each type of fracture. In addition, despite the wide range of EMF based treatments and devices for bone fractures, the mechanisms of action of each technique are not yet completely understood. The present study reviews the mechanisms of action of different EMF techniques for bone fracture.