The clinical and radiological outcome of pulsed electromagnetic field treatment for acute scaphoid fractures

A randomised double-blind placebo-controlled multicentre trial

P. F. W. Hannemann, K. W. A. Göttgens, B. J. van Wely, K. A. Kolkman, A. J. Werre, M. Poeze, P. R. G. Brink

Abstract

The use of pulsed electromagnetic fields (PEMF) to stimulate bone growth has been recommended as an alternative to the surgical treatment of ununited scaphoid fractures, but has never been examined in acute fractures. We hypothesised that the use of PEMF in acute scaphoid fractures would accelerate the time to union by 30% in a randomised, double-blind, placebo-controlled, multicentre trial. A total of 53 patients in three different medical centres with a unilateral undisplaced acute scaphoid fracture were randomly assigned to receive either treatment with PEMF (n = 24) or a placebo (n = 29). The clinical and radiological outcomes were assessed at four, six, nine, 12, 24 and 52 weeks.

A log-rank analysis showed that neither time to clinical and radiological union nor the functional outcome differed significantly between the groups. The clinical assessment of union indicated that at six weeks tenderness in the anatomic snuffbox (p = 0.03) as well as tenderness on longitudinal compression of the scaphoid (p = 0.008) differed significantly in favour of the placebo group.

We conclude that stimulation of bone growth by PEMF has no additional value in the conservative treatment of acute scaphoid fractures.

Footnotes

  • We would like to thank Dr E.S. van der Linden from the department of radiology of the Maastricht University Medical Centre for additional assessment of the radiographs.

    No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

  • Supplementary material. A table detailing the radiological outcomes of each group at each time point is available with the electronic version of this article on our website www.bjj.boneandjoint.org.uk

  • Received December 3, 2011.
  • Accepted June 27, 2012.
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