Electrical Stimulation of Acute Fractures: A Narrative Review of Stimulation Protocols and Device Specifications

Frontiers in Bioengineering and Biotechnology

Andrew J. Shoffstall¹  Kip A. Ludwig⁴  Allison J. Setiz⁵  Samuel O. Poore⁵  Peter J. Nicksic⁵  D’Andrea T. Donnelly⁵  Aaron M. Dingle⁵  Nishant Verma⁶ 

[1] APT Center, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, United States;Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States;Department of Biomedical Engineering, University of Wisconsin—Madison, Madison, WI, United States;Department of Neurological Surgery, University of Wisconsin—Madison, Madison, WI, United States;Division of Plastic Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States;Wisconsin Institute for Translational Neuroengineering (WITNe), University of Wisconsin—Madison, Madison, WI, United States;

关键词: electrical stimulation;    fracture;    human;    direct current;    pulsed electromagnetic field;    capacitive coupling;   

DOI  :  10.3389/fbioe.2022.879187

来源: DOAJ

【 摘 要 】

Orthopedic fractures have a significant impact on patients in the form of economic loss and functional impairment. Beyond the standard methods of reduction and fixation, one adjunct that has been explored since the late 1970s is electrical stimulation. Despite robust evidence for efficacy in the preclinical arena, human trials have mixed results, and this technology is not widely accepted. The purpose of this review is to examine the body of literature supporting electrical stimulation for the purpose of fracture healing in humans with an emphasis on device specifications and stimulation protocols and delineate a minimum reporting checklist for future studies of this type. We have isolated 12 studies that pertain to the administration of electrical stimulation for the purpose of augmenting fracture healing in humans. Of these, one was a direct current electrical stimulation study. Six studies utilized pulsed electromagnetic field therapy and five used capacitive coupling. When examining these studies, the device specifications were heterogenous and often incomplete in what they reported, which rendered studies unrepeatable. The stimulation protocols also varied greatly study to study. To demonstrate efficacy of electrical stimulation for fractures, the authors recommend isolating a fracture type that is prone to nonunion to maximize the electrical stimulation effect, a homogenous study population so as to not dilute the effect of electrical stimulation, and increasing scientific rigor in the form of pre-registration, blinding, and sham controls. Finally, we introduce the critical components of minimum device specification reporting for repeatability of studies of this type.

【 授权许可】

Unknown