Review Article

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

Ioannis D. Aifantis¹, Pantelis K. Mitsikostas²

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

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

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Abstract

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.

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