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JRPMS Vol 5, No 3, September 2021, p.110-115

doi: 10.22540/JRPMS-05-110


Review Article

The role of biophysical enhancement (LIPUS, ESWT and PEMF’s) in fracture healing

Ioannis D. Aifantis1, Pantelis K. Mitsikostas2

  1. 2nd Orthopaedic Department, KAT Hospital, Kifissia, Greece
  2. 1st Orthopaedic Department, KAT Hospital, Kifissia, Greece

Keywords: ESWT, Fracture healing, LIPUS, Nonunion, PEMF


Fracture healing is a biological route that may not always lead to bone healing. Delayed union or even nonunion of a fracture is possible to have devastating socio-economic impact on patients and healthcare systems. Except of surgical treatment, other non-invasive methods have been proposed for the management of non-united fractures commonly known as biophysical enhancement. This includes low-intensity pulsed (LIPUS), extra-corporeal shockwave therapy (ESWT) and pulsed electromagnetic fields (PEMF) stimulation. The utility and efficacy of biophysical enhancement is a matter of question and no safe conclusion can be drawn especially because of great heterogeneity present in literature.