Fractures are a common occurrence, especially for active individuals. Most heal on their own with proper immobilization using Trauma Instruments & implants. However, in some cases, fractures can become stubborn and refuse to mend. This is where bone growth stimulators (BGS) come into play as a valuable tool in the orthopedic surgeon’s arsenal.
Understanding Nonunions
A nonunion is a fracture that fails to heal completely within the expected timeframe. Here are some of the reasons for nonunions:
Insufficient blood supply
Bones need a steady flow of blood to deliver oxygen and nutrients for healing. Injuries that damage nearby blood vessels can hinder this process.
Bone instability
Constant movement at the fracture site can disrupt the healing cascade. This can be caused by inadequate immobilization or certain types of fractures.
Medical conditions
Certain medical conditions like diabetes or osteoporosis can weaken bones and make them more susceptible to nonunions.
How Bone Growth Stimulators Work?
Bone growth stimulators are devices that deliver low-intensity pulsed electromagnetic fields (PEMFs) or ultrasound waves to the fracture site. These gentle waves mimic the body’s natural electrical signals involved in bone healing. The exact mechanism of action is still under investigation, but BGS therapy is believed to:
Increase blood flow
Pulsed electromagnetic field therapies (PEMFs) or ultrasounds can stimulate the growth of new blood vessels around the fracture, enhancing nutrient delivery and bone formation.
Promote bone cell activity
The gentle stimulation can trigger osteoblasts, the cells responsible for building new bone, to become more active.
Improve bone mineralization
BGS therapy may enhance the deposition of calcium and other minerals, leading to stronger and denser bone at the healing site.
What Are the Types of Bone Growth Stimulators?
There are two main types of BGS devices used in orthopedic surgery:
External BGS
These are non-invasive devices worn externally over the fracture site. They consist of a control unit and electrodes or a coil that emits the PEMFs or ultrasound waves. External BGS are comfortable, portable, and allow for continued mobility during treatment.
Internal BGS
These are surgically implanted devices placed near the fracture site. Internal BGS offers more targeted stimulation but requires a minor surgical procedure for placement and removal.
When are Bone Growth Stimulators Used?
BGS therapy is typically considered for nonunions after a period of conservative treatment with casting or bracing has failed to show progress. They are also used in certain high-risk fractures or following surgeries like spinal fusions, where promoting bone healing is crucial for a successful outcome.
What Are the Benefits of Bone Growth Stimulator Therapy?
BGS offers several advantages over traditional treatment methods for nonunions:
Non-invasive (external BGS)
Eliminates the need for additional surgery, reducing risks and recovery time.
Painless
The low-intensity stimulation is generally well-tolerated and does not cause pain.
Promotes faster healing
BGS therapy can significantly accelerate the healing process compared to relying solely on the body’s natural mechanisms.
Improves bone quality
BGS can help create denser and stronger bone at the fracture site.
What Are the Limitations of Bone Growth Stimulator Therapy?
While BGS is a valuable tool, it’s important to understand its limitations:
Not a guaranteed fix
BGS therapy is not always successful, and individual results can vary.
Treatment duration
Treatment can take several months, requiring dedicated patient compliance.
Not suitable for all fractures
BGS is not effective for all types of fractures and may not be recommended in certain cases.
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