Percutaneous electrical stimulation for clinical tibial fracture repair

Observations on stress generated electrical currents in bone have stimulated interest in the possible osteogenetic effect of externally applied electrical energy to establish diaphyseal bone defects in animals and man. This report records the observed effects of pulsed electrical energy directed through a metal (Riordan pin) electrode placed in a large proximal tibial shaft dedect in a young man who sustained loss of bone from a gunshot wound. The fixation pin placed directly into the defect provided the cathode (-) electrode. The anode (+) electrode consisted of an aluminum foil band placed on the skin adjacent to the leg. The tibia had 282 consecutive days of electrical stimulation and provided X-ray and clinical evidence of enhanced osteogenetic activity. The degree of osteogenetic response attributable to the electrical stimulation is undetermined because other factors, including cast immobilization, time and minimal touchdown (25 pounds) weight-bearing in the cast during the period of observation, may also have had some influence on the healing response. Circumstantial clinical evidence indicates that the applied electrical energy was of primary importance in the healing process. This theoretically and technically acceptable source of osteogenetic activity merits continued, intensive investigation.