Treatment of non-union with implanted direct current stimulator and bone grafting

ABSTRACT

This study presents the results of 38 cases of ununited long bone fracture treated by a totally implanted direct current bone growth stimulator and by bone grafting. The patients were grouped into A, B, C, and D. Ten patients in Group A and 10 patients in Group B were cases of non-union with an average duration of 1 year, and had no history of a previous bone grafting procedure. Eight patients in Group C and 10 patients in Group D were cases of non-union with an average duration of 2 1/2 years and had multiple previous unsuccessful attempts to achieve union. Patients in Group A were treated by a bone growth stimulator and internal fixation; in Group B, by internal fixation and bone grafting; in Group C, by a bone growth stimulator combined with internal fixation and bone grafting; and patients in Group D were treated by internal fixation and bone grafting. The success rate of sound bone union in Group A was 90%, in Group B 80%, in Group C 62.5%, and in Group D, 70%. This study suggests that the bone growth simulator, combined with internal fixation is a satisfactory method for the treatment of non-union operated first time and it avoids the need of bone grafting. The use of a bone growth stimulator, in conjunction with bone grafting in cases of non-union with a history of previous failed surgical procedures, did not make any difference to the results: