Carpal scaphoid non-union treatment: a retrospective trial comparing simple retrograde percutaneous screw fixation versus percutaneous screw fixation plus pulsed electromagnetic fields (Physiostim®)
- 203 Downloads
The purpose of this retrospective comparative study was to assess whether a complementary treatment by pulsed electromagnetic field could increase the bone-healing rate of scaphoid non-union without SNAC (scaphoid non-union advanced collapse) treated by retrograde percutaneous screw fixation.
Eighteen patients with scaphoid non-union were included in this retrospective study. The group 1 was made of nine cases (seven stage IIA and two stage IIB) of scaphoid non-union treated by retrograde percutaneous screw fixation and pulsed electromagnetic fields (Physiostim®). The group 2 was made of nine cases (six stage IIA and three stage IIB) treated by simple retrograde percutaneous screw fixation.
With a 10-month follow-up in group 1 and a 9.5-month follow-up in group 2, there were three cases of non-union in group 1 and two cases in group 2. Regarding the type of non-union, there was one case among the stage IIB and four cases among the stage IIA.
The results of the study did not show any interest in the use of pulsed electromagnetic field for the treatment of carpal scaphoid non-union. They should be dropped.
Level of evidence
KeywordsScaphoid Non-union Electrostimulation Physiostim® Percutaneous screw fixation Pulsed electromagnetic field
Thanks to Mickaël Schaeffer, Department of Medical IT, Strasbourg University Hospitals, Strasbourg, France, who performed the statistical analysis.
Compliance with ethical standards
Conflict of interest
Philippe Liverneaux has conflicts of interest with Newclip Technics, Argomedical, iiN medical. None of the other authors have conflicts of interest.
- 5.Bodamyali T, Bhatt B, Hughes FJ, Winrow VR, Kanczler JM, Simon B, Abbott J, Blake DR, Stevens CR (1998) Pulsed electromagnetic fields simultaneously induce osteogenesis and upregulate transcription of bone morphogenetic proteins 2 and 4 in rat osteoblasts in vitro. Biochem Biophys Res Commun 250:458–461CrossRefPubMedGoogle Scholar
- 18.Hannemann PF, van Wezenbeek MR, Kolkman KA, Twiss EL, Berghmans CH, Dirven PA, Brink PR, Poeze M (2014) CT scan-evaluated outcome of pulsed electromagnetic fields in the treatment of acute scaphoid fractures: a randomised, multicentre, double-blind, placebo-controlled trial. Bone Joint J 96:1070–1076CrossRefPubMedGoogle Scholar
- 22.Foley KT, Mroz TE, Arnold PM, Chandler HC Jr, Dixon RA, Girasole GJ, Renkens KL Jr, Riew KD, Sasso RC, Smith RC, Tung H, Wecht DA, Whiting DM (2008) Randomized, prospective, and controlled clinical trial of pulsed electromagnetic field stimulation for cervical fusion. Spine J 8:436–442CrossRefPubMedGoogle Scholar
- 23.Griffin XL, Costa ML, Parsons N, Smith N (2011) Electromagnetic field stimulation for treating delayed union or non-union of long bone fractures in adults. Cochrane Database Syst Rev 13:CD008471Google Scholar
- 25.Hannemann PF, Mommers EH, Schots JP, Brink PR, Poeze M (2014) The effects of low-intensity pulsed ultrasound and pulsed electromagnetic fields bone growth stimulation inacute fractures: a systematic review and meta-analysis of randomized controlled trials. Arch Orthop Trauma Surg 134:1093–1106CrossRefPubMedGoogle Scholar
- 26.Shi HF, Xiong J, Chen YX, Wang JF, Qiu XS, Wang YH, Qiu Y (2013) Early application of pulsed electromagnetic field in the treatment of postoperative delayed union of long-bone fractures: a prospective randomized controlled study. BMC Musculoskelet Disord 14:35CrossRefPubMedPubMedCentralGoogle Scholar