A review of delayed unions of open tibia fractures treated with external fixation and pulsing electromagnetic fields

Seventeen cases of open tibia fractures complicated by delayed union were reviewed. Only severe injuries requiring external fixation for tissue management and multiple surgical procedures were included in this study. All were ultimately treated with pulsing electromagnetic fields. Our purpose was to evaluate the efficacy of electrical stimulation in these cases and any synergism with combined surgical procedures. Fifteen of 17 cases (88.2%) united within an average of 5.65 months after electrical stimulation was implemented. The average time interval from injury to application of electrical stimulatin was 13.75 months. Pin tract infections occurred in an alarmingly high number of patients; however, all responded to treatment. A notable synergistic relationship with bone grafting was found when stimulation was applied postoperatively.