Biophysical Enhancement in Fracture Healing: A Review of the Literature.

Bone healing constitutes a complex process involving cellular and pathophysiological mechanisms. Despite progress in osteosynthesis techniques, fracture union continues to be challenging. In some cases, it is not ultimately achieved or is delayed relative to the expected time resulting in economic and social outcomes for the patient and the health system. In addition to surgical treatment, biophysical methods have been developed to assist in fracture healing used in combination or individually. Biophysical stimulation is a non-invasive therapy used in orthopedic practice to increase and enhance tissue's reparative and anabolic activities. This study reviewed the existing literature, including electromagnetic fields, ultrasound, laser, extracorporeal shockwave therapy, and electrical stimulation, and revealed the efficacy of biophysical stimulation for bone healing. This study aims to define if these methods are helpful, especially in cases of non-union. Biophysical stimulation requires care and precision in use to ensure the success expected of it by physicians and patients.

Drill-guided femoral nail extraction: a novel technique.

Femoral nail extraction, although it is considered a challenging procedure for orthopedic surgeons, can be simplified. We present a new technique to aid the removal of a proximally (antegrade) inserted femoral nail by applying drilling consecutively in order to identify the margins and depth of the nail into the intramedyllary canal of the femur. The damage to the bone is minimal as we use k-wires or drilling and in our practice was uneventful. This technique is the first to be reported in literature. Most authors suggest techniques that enable radiolucent table and fluoroscopy techniques using C-arm. With this technique, traction table and fluoroscopy techniques seem to be less essential to accomplish the removal of a proximally (antegrade) inserted femoral nail.