Adjunctive hyperbaric oxygen therapy in the treatment of atrophic tibial nonunion with Ilizarov external fixator: a radiographic and scintigraphic study in rabbits.

OBJECTIVE: The aim of this experimental study was to determine the effects of adjunctive hyperbaric oxygen therapy (HBO) on atrophic tibial nonunion treatment using Ilizarov external fixator. METHODS: Twenty New Zealand white rabbits were randomly divided into two equal groups. A circular external fixator was applied to the right tibia of all the rabbits. A 5-mm bone block was resected and a tibial pseudarthrosis was obtained after a 6-month waiting period. The experimental group rabbits (n=10) underwent daily 2.5 ATA HBO therapy for 2 hours for 20 days and the control group rabbits (n=10) did not receive any corresponding treatment. Osteoblastic activity was evaluated with bone scintigraphy on days 30 and 90. Fracture healing was evaluated by plain radiographs on days 30 and 90. RESULTS: On Day 30, radiological scores were statistically similar in both groups (p=0.167). However, on Day 90, the experimental group displayed significantly higher radiological scores (p<0.001). Osteoblastic activity was also higher in the experimental group on both scintigraphic assessments (p=0.005 and p=0.001). CONCLUSION: The results of this study suggest that HBO can be used as a supplementary therapy in the management of atrophic tibial nonunion.

Tratamiento de la pseudoartrosis séptica y recalcitrante de la diáfisis humeral mediante impactación intramedular / Treatment of the septic and recalcitrant humeral shaft nounion by means intramedullary impactation

Se presenta un caso de una fractura de la diáfisis humeral complicada con una pseudoartrosis recalcitrante, infección y parálisis radial. Se propone una alternativa de tratamiento que, por su sencillez y aplicabilidad, puede incluirse en el arsenal terapéutico para solucionar esta grave patología (AU)

We present a case of humeral shaft fracture complicated with recalcitrant nonunion, infection and radial nerve paralisys. A treatment alternative sets out that, by its simplicity and applicability, deserves to have it in account within the therapeutic arsenal which we arrange to the solution of this serious pathology (AU)

Electrical stimulation therapies for spinal fusions: current concepts.

Electrical stimulation therapies have been used for more than 30 years to enhance spinal fusions. Although their positive effects on spinal fusions have been widely reported, the mechanisms of action of the technologies were only recently identified. Three types of technologies are available clinically: direct current, capacitive coupling, and inductive coupling. The latter is the basis of pulsed electromagnetic fields and combined magnetic fields. This review summarizes the current concepts on the mechanisms of action, animal and clinical studies, and cost justification for the use of electrical stimulation for spinal fusions. Scientific studies support the validity of electrical stimulation treatments. The mechanisms of action of each of the three electrical stimulation therapies are different. New data demonstrates that the upregulation of several growth factors may be responsible for the clinical success seen with the use of such technologies.

[Treatment of infected pseudoarthroses with electrodynamic field therapy]. / Behandlung infizierter Pseudarthrosen mit der elektrodynamischen Feldtherapie.

The electrodynamic field treatment, its method and fundamentals in the therapy of infected, atrophic pseudarthrosis are described. In addition to the common principles of treatment, particularly the transplantation of autologous spongious bone is of great importance. The bone graft reestablishes normal electrical conduction within the pseudarthrosis and as a reactive receptor for the applied a.c.-potentials consolidates the defect. Up to now in 8 years of employing this method 271 patients, suffering from pseudarthroses have been treated, 91 of them had an infected, often atrophic pseudarthrosis. In each group in 92% of the cases bony healing could be achieved. Some case reports demonstrate clinic and therapy.

[Electromagnetic fields and alternating current, do they accelerate bone healing? (author's transl)]. / Fördern niederfrequentes Magnetfeld und Wechselspannung die Knochenheilung?

The effects of combined treatment with electromagnetic fields and alternating current according to the method of Kraus is investigated in two groups at bone-nonunions of 21 beagle-dogs. Identical atrophic nonunions of both ulnae are stabilized with plates and treated electrically for eight weeks at one side only, the other side serves as control. The second group gets an additional cancellous bone graft. Qualitative and quantitative evaluation of X-rays and histology of undecalcified bone shows better bone healing in the group with cancellous bone graft on the treated side compared with the control. The first group shows no remarkable differences between both sides, except an increased periosteal bone formation around the active implants.

[The effect of so-called electrodynamic potentials on experimental reaction-poor pseudarthrosis]. / Die Wirkung sogenannter elektrodynamischer Potentiale an experimentellen reaktionsarmen Pseudarthrosen.

The effect of the magnetic field and the alternating current according to the Kraus-Lechner model was investigated on experimental pseudarthroses in beagle dogs. The evaluation of 16 pseudarthroses showed no effect of the method Kraus-Lechner on healing.

[Electromagnetic stimulation of infected experimental pseudarthrosis in a left-right study of beagles]. / Elektromagnetische Stimulation infizierter Defektpseudarthrosen im Rechts-Links-Versuch am Beagle.

Electromagnetic AC-stimulation according to the method of KRAUS was applied in 9 infected ununited ulnar fractures in the beagle. New cortical bone formation, bridging of the bone defect and the number of blood vessels in bone and soft tissue was assessed. Electromagnetic stimulation had no significant influence on bone healing or on the number of vessels.