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Pulsed electromagnetic field (PEMF) treatment for fracture healing

Boopalan, PRJVCa; Chittaranjan, Samuel Ba; Balamurugan, Ramadassa; Nandakumar, NSa; Sabareeswaran, Ab; Mohanty, Mirab

doi: 10.1097/BCO.0b013e318198e8b2

Background Pulsed electromagnetic field (PEMF) therapy is used as an adjuvant therapy for promoting fracture healing. We performed this study in an animal model to determine the efficacy of PEMF therapy in fracture healing and to identify and quantify growth factor TGF-ß1 and TGF-ß2 by quantitative reverse transcription-polymerase chain reaction (RT-PCR) analysis.

Methods The study was conducted in Wistar rats, with six study and six control animals. The right midshaft femur of all 12 animals was osteotomized to create a gap of 5 mm and transfixed with a Kirshner wire. Baseline quantitative RT-PCR analysis was done with the removed bone. The six animals from the study group were given PEMF of 1 hour duration, twice a day for 6 weeks. Radiographic images were obtained in all animals at 1, 3, and 6 weeks. At 6 weeks all the animals were euthanized, and 1.5 cm of bone, including the previous osteotomy site, were analyzed. RT-PCR analysis for TGF-ß1 and TGF-ß2 and histological analysis was done to compare bone healing between the control and study animals. The bone weight also was measured.

Results A significant increase in bone formation was shown by histomorphometry in the study group. Increased expression of TGF-ß1 and TGF-ß2 was present in the study animals. Although bone weight had increased in the study group, it was not statistically significant.

Conclusions PEMF therapy may be useful as an adjuvant treatment for fracture healing. The mechanism of healing seems to be secondary to local expression of growth factor TGF-ß at the fracture site.

aChristian Medical College, Vellore, TamilNadu, India

bSree Chitra Tirunal Institute for Medical Sciences and Technology, Poojapura, PIN, India

Correspondence to P.R.J.V.C. Boopalan, D Ortho, MS Ortho, Department of Orthopaedics Unit III, Christian Medical College, Vellore, TamilNadu, India – 632004, India Tel: +914162282091; fax: +914162232035; e-mail:

This study was supported by the Fluid Research Fund from Christian Medical College, Vellore. The Department of Gastrointestinal Sciences laboratory received support from the FIST (Fund for improvement of Science and Technology Infrastructure) program of the Department of Science and Technology, Government of India.

© 2009 Lippincott Williams & Wilkins, Inc.