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What to Know About Bone Stimulators for Fracture

Medically Reviewed by Dan Brennan, MD on June 05, 2021

Electrical stimulation therapy is a recent, popular alternative treatment. Bone growth stimulators are sometimes used for fractures that haven’t healed on their own. 

Are bone stimulators effective?

Broken Bones

A bone may be partially or completely fractured. There are several different types of fractures, including:

  • Open or compound fractures, where the skin is broken
  • Transverse fractures, also known as horizontal fractures
  • Oblique fractures, which have an angled pattern
  • Comminuted fractures, where a bone breaks into three or more pieces
  • Stable fractures, where pieces of the broken bone are lined up

After treatment, your body works to form new bone tissue and connect your broken bone together. For a fracture to heal, your bone needs stability, good blood supply, and nutrition. 

Nonunion and Delayed Union Fractures

Most broken bones heal without problems. Out of an estimated 7.9 million fractures that happen each year in the United States, 5% to 10% of them don’t heal (nonunion) or take a longer than usual time to heal (delayed union).

Nonunion fractures typically happen when your bone doesn’t have enough blood flow or stability, or both. These fractures are also more likely if they were caused by a severe injury, like the kind experienced in a car crash, which reduces blood supply to the affected area.

Some other factors also increase the risk of your fracture not healing on its own, including:

If a broken bone doesn’t heal in nine months, it’s considered a nonunion fracture.

What Are Bone Stimulators?

A bone stimulator is a device that generates an electric current meant to encourage bone growth. It uses ultrasonic or pulsed electromagnetic waves. To be effective, bone stimulator treatment must be used every day. 

Bone stimulators are either external or surgically implanted into the area of the affected bone. An implanted stimulator allows for constant stimulation directly at the fracture site but may cause infection.

Are Bone Stimulators Effective?

The effectiveness of electrical bone stimulators hasn’t been determined, and studies have had mixed results.

A 2008 review of scientific trials on electric stimulators found that pain was reduced in only one of the four trials.

Studies of the use of electrical bone stimulation have also found that it may speed up healing time in smokers.

One study found that healthcare costs were lower among those who used bone stimulators compared to those who received low-intensity pulsed ultrasound stimulation or neither treatment for their nonunion fractures.

But a different study found that those receiving bone stimulators had higher health-related costs over a year compared to those who didn't use stimulators.

Other experts say that recent data doesn’t show the benefit of the use of these stimulators. They say that improvements in modern surgical techniques may have lessened the potential benefit of stimulators.

Cost of Bone Stimulators

If your doctor has prescribed a bone stimulator, check with your insurance to see if they cover the cost, or ask your doctor how much it will cost. The cost may depend on the manufacturer and type of bone stimulator.

An implanted electrical stimulator may cost up to $5,000.

Are Bone Stimulators Safe?

The use of bone stimulators hasn’t been found to cause any adverse side effects.

Experts say that bone stimulators shouldn’t be used in these situations:

  • Pregnant women
  • People with a growth disorder (skeletal immaturity)
  • If your bone is stabilized with magnetic materials
  • If your fracture gap is greater than 50% of the diameter of the bone
  • If you have a “false joint” (pseudarthrosis)
  • If you have a pacemaker or a defibrillator, unless you talk to your cardiologist first

Other Treatment Options for Nonunions

Treat the cause. In many cases, your doctor may be able to identify and treat the cause of the nonunion. There are many causes and factors of nonunions such as lack of Vitamin D and inadequate immobilization that can be reversed and treated.

Nutrition. Your fracture needs good nutrition to heal. Eat a well-balanced diet that includes calcium, vitamins C and D, and protein. Supplements aren’t usually effective unless you’re severely malnourished. 

Bone graft. In this type of surgery, your doctor will use bone from another part of your body or from a cadaver to help start the healing process. Bone grafts provide fresh bone cells and chemicals that your body needs for bone healing. 

Bone harvesting is usually done from the rim of your pelvis. It may be painful but won’t cause any structural, functional, or cosmetic problems. 

Bone grafts don’t provide stability to the fracture site, though, so you may need some type of fixation to improve stability, such as: 

  • Internal fixation. This involves placing a rod in the inside canal of the bone or attaching metal screws and plates to the outside of the bone. 
  • External fixation. This uses a rigid frame to the outside of your affected arm or leg using pins or wires.
WebMD Medical Reference

Sources

SOURCES: 

Asian Spine Journal: “Trends and Costs of External Electrical Bone Stimulators and Grafting Materials in Anterior Lumbar Interbody Fusion.”

Clinical Orthopaedics and Related Research: “Treatment of delayed union and nonunion with an implanted direct current stimulator.”

Indian Journal of Orthopaedics: “Bone stimulation for fracture healing: What's all the fuss?”

Journal of Bone and Joint Surgery: American Volume: “Electrical stimulation for long-bone fracture-healing: a meta-analysis of randomized controlled trials.”

Journal of Diabetes and Metabolism: “Cost Savings Associated with the Use of Electrical Bone Growth Stimulation to Treat Diabetic Patients in the U.S. with Fracture Nonunion.”

OrthoInfo: “Fractures (Broken Bones),” “Nonunion.”

PodiatryToday: “Bone Growth Stimulation: What The Evidence Reveals.”

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