According to the College of Orthopedic Surgeons “During the past 30 years, doctors have noted an increase in the number and severity of broken ankles, due in part to an active, older population of “baby boomers.” In 2003, nearly 1.2 million people visited emergency rooms because of ankle problems. The ankle actually involves two joints, one on top of the other. A broken ankle can involve one or more bones, as well as injuring the surrounding connecting tissues (ligaments).
There is a new and non-invasive way to handle such fractures, that in many cases, can help avoid surgical pinning, and shorten healing time. Called bone growth stimulators, these therapies use either electromagnetic or ultrasound to stimulate growth of fresh healthy tissue.
Although for extremely traumatic breaks, these devices can be surgically implanted, in most cases they can be applied through a port cut into a stabilizing cast. The application which normally is done 20 minutes a day is easy to use and painless. The port has a snap on cover, that remains closed when not in use, and is filled with a cotton plug to prevent edema of the area immediately under the port. This is removed when the leads for the stimulator are placed inside the port directly on the skin over the fracture site.
Contrasted against the risks of complications from surgical interventions such as pinning and plating, this is a safe and much less risky treatment modality. It is mainly used in patients who are failing to heal from fractures that have occurred over 3 months or more prior to treatment with these devices. Indications for use are non-union fracture healing with a distance of 1 centimeter or less. Patients who smoke, have a history of alcoholism or are suffering with lupus, diabetes or other autoimmune disorders, are considered prime candidates for this therapy.
One of the major considerations in deciding to use this type of device is length of time in failing to heal. With bone growth stimulation, healing occurs over 86% of the time. It also appears to have some positive benefits on patients who are also suffering from osteoporosis, though major double blind studies are not complete on this. The newer ultrasound device is much less known than the pulsating electromagnetic stimulator. Studies on this have been fairly extensive and have been used both as surgical implants and external, through a port method.
“The theory behind applying an electric current to fractures to stimulate healing is based on the fact that the concave side of the bone becomes negatively charged and the convex side is positively charged. It is believed that artificially encouraging this charging with an electric current will speed healing. In 1996, the Food and Drug Administration (FDA) also approved the application of low intensity ultrasound pulses as a treatment for fracture nonunion.” And while the newer ultrasound device takes 20 minutes a day, the electromagnetic stimulator can require up to 10 hours per day in at least one hour increments to be effective.
Patients considering this form of therapy need to be told they must be totally non-weight bearing through the entire course of treatment, which can run 3-6 months. This is a big sacrifice in terms of time and inconvenience. On the positive side, there are no complications with this type of fracture treatment, it is painless, and the risk of infection is minimal. Contrast this with the pain, anesthesia, recovery and complications of major surgery, which can realistically keep you ill much longer than this.
Children under 17 years of age are not considered for this procedure, as their bones are still growing and fusing. Current studies are being done on spinal fusion patients and those with skull fractures, where it appears the bone growth stimulator may be of enormous benefit. Most major insurance companies will cover the use of bone growth apparatus, if the patient fits their criteria for use. Once approved, your physician and a representative from the company will help instruct you and set you up with your stimulator. You will be given a toll free number to call if problems arise or you need assistance with equipment or supplies.
I’ve been using mine for a week now and am amazed at how easy and quick it is to set up and use. And it is simply awesome that modern medicine can provide such a great alternative to painful and often fatal surgical interventions in patients like myself. Though it may not be a quick and easy solution, it is a safe one for people who cannot heal on their own.