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Pulsed electromagnetic fields after intramedullary nailing of tibial fractures: a case control study

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Abstract

Purpose

To compare clinical and functional outcomes of two groups of patients undergoing reduction and nailing fixation for diaphyseal fractures of the tibia with (PEMF group) and without (control group) post-operative pulsed electromagnetic field (PEMF) application.

Methods

This is a retrospective study on 50 patients (mean age 43.3 years, 28 males and 22 females) with diaphyseal tibial fractures managed between 2017 and 2019. Twenty-five patients underwent reduction, nailing fixation, and PEMF application post-operatively (PEMF group) and 25 patients underwent nailing fixation. Radiographic imaging assessment was performed every month until fracture healing had been evident. Use of analgesics, fracture healing time, post-operative lower limb alignment, and post-operative complications were recorded. Patients were asked about return to preinjury activity. All patients were assessed at 3 months and at an average follow-up of 13 months. The VAS scale and Johner-Wruhs criteria were used for pain assessment and functional recovery, respectively.

Results

Comparing groups, VAS values were significantly lower in the PEMF group at three months and comparable at one year. The patients in the PEMF group took an average of 4.1 months to resume their preinjury activities, and control patients took an average of 5.3 months (P < 0.0001). According to the Johner-Wruhs score, the effective rate was 100% (25/25) in the PEMF group and 92% (23/25) in the control group (P = 0.14).

Conclusions

PEMF application after intramedullary nailing is safe and reduces post-operative pain, use of analgesics, and the time of healing fracture. At one year, there is no difference in outcome measures, regardless of PEMF application.

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Author information

Authors and Affiliations

  1. Unit of Orthopedics and Trauma Surgery, L. Curto Hospital, Polla, Italy

    Angelo Del Buono

  2. Department of Orthopedics and Trauma Surgery, Campus Bio-Medico University of Rome, Via Alvaro del Portillo, 200, 00128, Rome, Italy

    Biagio Zampogna & Rocco Papalia

  3. Unit of Arthroscopy and Sports Medicine, Hesperia Hospital, Modena, Italy

    Leonardo Osti

  4. Department of Shoulder Surgery and Sport Trauma Surgery, F. Miulli Hospital, Acquaviva Delle Fonti, BA, Italy

    Alberto Fontanarosa & Raffaele Garofalo

Authors
  1. Angelo Del Buono
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  2. Biagio Zampogna
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  3. Leonardo Osti
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  4. Alberto Fontanarosa
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  5. Raffaele Garofalo
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  6. Rocco Papalia
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Contributions

ADB examined all patients preoperatively, taking account of history, clinical examination, and radiographic findings and performed all surgical procedures.

BZ and AF examined all the patients and collected the data and wrote the paper.

LO performed the statistical analysis and contributed to the final manuscript.

RG and RP conceived and designed the analysis, helped supervise the project, and contributed to the final manuscript.

Corresponding author

Correspondence to Rocco Papalia.

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All the authors declare that the procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 and 2008.

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Not applicable.

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The manuscript has been read and approved by all the authors and each of them considered it an honest production by our research group.

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The authors declare no competing interests.

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Del Buono, A., Zampogna, B., Osti, L. et al. Pulsed electromagnetic fields after intramedullary nailing of tibial fractures: a case control study. International Orthopaedics (SICOT) 45, 2945–2950 (2021). https://doi.org/10.1007/s00264-021-05125-y

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