Treatment of delayed union and nonunion with an implanted direct current stimulator.

A multicentered research program on direct electrical current for stimulation of bone healing was performed by 30 Australian orthopedic surgeons. The program was designed to test an implanted device named direct current bone growth stimulation (DCBGS). The DCBGS achieved union in 72 of 84 (86%) cases of ununited fractures of long bones. These results are comparable to those obtained with other devices. The time to achieve sound union however, appears to be significantly less than by conventional bone grafting techniques. The procedure is safe and simple, with a short hospital stay and low rate of complications. Certain technical details have been stressed. The presence of previous infection is not a contraindication to this procedure. The procedure has advantages over Phemister or Charnley bone graft operations in that it produces less pain, generally avoids the need for a cancellous bone graft and allows an anterior approach to the shaft of the tibia when this might otherwise not be possible. The results for the various techniques of applying electric stimulation to bone are generally comparable although the clinical indications favoring one technique over another have yet to be determined. Electric stimulation used as described is an effective method of treatment for ununited fractures of long bones.