Bone has a unique way to heal itself through mechanical, as well as through electrical and magnetic means. Wolff's Law states, " bone adapts its structure to its mechanical loading conditions." However, Wolff is not the first to experiment with the idea of using stimulation to speed the rate of healing a fractured bone. In the 1950's, Japanese doctors, Yasuda and Fukada, are believed to be the first to recognize the potentials of electricity and bone. Since then, orthopedics has been studying the field of using stimulation, by means of electricity and ultrasound, to speed the recovery rate of a fracture. Dozens of publications have been presented to the medical community to show the outstanding benefits of using these devices. Through the understanding of how electricity works in the body, medicine has allowed everyone the opportunity to access of these machines. While my emphasis is on the healing of athletes, these devices are plainly put, for the healing of a bone fracture regardless of age or activity. In America, it is estimated that 300,000 elderly people suffer from hip fractures alone. That statistic is for the elderly age group, and the number is outstanding by itself. The bone growth stimulators help by either using electrical currents to stimulate the body's own manipulation of electricity or by using ultrasound waves to allow the fracture site to stay "fresh" so that healing process isn't hindered.

Personally, I have used such a device, Ultrasonic Bone Growth Stimulator, and had great results. While I don't have the images to show, I can say that these devices work. I am an athlete that suffered a broken femur during a football game. The injury itself was one of a kind, some might call it "An act of God." It was extremely painful and the surgery took over 5 hours to complete. A devastating injury to overcome, but all the while I had my mind set on returning to the playing feild the following season. I spoke to my orthopedic surgeon about possible ways and methods to speed the healing process, and he brought to my attention the Ultrasonic Bone Growth Stimulator. I didn't question the method, I just wanted to be on my feet as soon as possible. Besides, my orthopedic surgeon is very well respected in my community, so trust was never a question. Anyway, he prescribed the device for me, showed me how to use it, and I let the machine work it's magic. To my delighted surprise, every visit to his office for x-rays showed a faster healing than I beleive would have occurred without such a device. Remember, I broke my femur, the biggest and strongest bone in the body, and after 4 months of using the bone growth stimulator, the x-rays didn't even show the fracture. It was at the moment that I saw those x-rays that I became a beleiver for life. I even think that my doctor couldn't believe how fast I had recovered from my injury. Please don't think that the device is all there is to it. In my case, it wasn't, I still had to complete the incredibly challenging road to recovery through physical therapy. However, had it not been for the speedy healing of my fracture, my rehabilitation process would have been pushed back and my goal maybe never accomplished. I red-shirted the following season, but I was involved in practice and taking hits.

Controversy surrounding such devices is unknown to me. We all know, however, that if one looks hard enough one will find an opposition to just about anything. I can think of only a couple of instances where opposition to such devices might be raised. One, is a religious group that believes that all injuries and sicknesses should be healed by the Lord. I believe in the Lord, however, I believe that He wouldn't have given humans the gift of intellect if he didn't want us to create cures for ourselves. Sorry, but I think that when medicine can play a helping hand, accept it. The other possible controversy would be the use of such devices to athletes that don't have an injury. Thus attempting to create stronger bones through the use of these devices. I haven't found any such documentation on such a thing, but we all know that the possibility exists. Would these machines work on bones that haven't been broken? Why not, they heal bones that have been broken. There the possibility exists. I personally would not favor such a method because I see a difference between healing an injury to get back to a pre-injury status and looking for a way to cheat the game.

Ethical decisions made by people working with these devices, doctors mainly, can probably be argued in a number of ways. How to determine who needs these devices more could be a topic of debate. A person, like myself, who wants to speed the healing rate so that they could get back on the playing field as fast as possible versus an elderly woman who needs to care for herself. While there is no reported shortage of these devices, I don't see an ethical dilemma stirring. Hypothetically, if there were a shortage of these devices and a doctor had to choose between a young athlete wanting to speed their healing rate or a housewife wanting to heal faster so that she can care for her family, then ethics could be raised. However, like I stated before there is no shortage of these devices so ethics in that regard is ruled out. Should someone not have the insurance that would cover for a device such as the bone growth stimulator, then their beef is with the insurance company not with someone who has the insurance provider that does cover such devices.

I realize that these devices aren't as well known as other medical technologies, however, they are important. Should they be a priority in health class, probably not. I do beleive that everyone should at least have the term bone growth stimulator in their memory bank. From what I understand, sometimes certain doctors require the injured to meet a certain criteria before the prescribe these devices. The criteria that some doctors require are in the links on my default page.

The relationship of this topic to the overall theme of this course is the use of biotechnology for the enhancement of an injury. Human life and well being are a value of our society. Such devices allow for the injured to recover from a broken bone much faster. By speeding the healing factor biotechnology allows innovation to play an integral part of our lives. My topic relates to Josh Spencer's topic of diabetic device used to measure a person's blood sugar level. While they do two completely opposite things, they are related because it is through devices such as ours that allow people to monitor, in Josh Spencer's topic, and to heal, in my topic, such ailments or injuries. The difference is obvious, my machine stimulates bone growth through electrical or ultrasonic waves into the fracture site. By using the body's own electrical energy the bone growth stimulator can accelerate the growth of new bone cells. In Josh Spencer's topic the blood monitor calculates the amount/ or lack of insulin in the blood thus allowing the diabetic to keep a balance so that their life isn't affected.

I have to use my own example of a case study because I can honestly say that I know these bone growth stimulators work. I broke my leg in the month of November and was prescribed the bone growth stimulator towards the end of November. When I saw my March x-rays I couldn't believe how miraculously fast my leg had healed. I couldn't thank my doctor enough.

Another case study from the following link: Stimulating Treatment

Treatment Results

Figure 1: Radiograph demonstrates a stress fracture of the proximal fifth metatarsal shaft (Jones fracture).

Efficacy studies are available in the peer-reviewed literature for each method of bone stimulation. Brighton and Pollack reported excellent results with capacitive coupling used to treat 22 previously treated recalcitrant nonunions. The average pretreatment duration of nonunion was 3.3 years and 17 of 22 (77%) healed with CC stimulation after an average of 22 weeks.2 Scott and King showed significant improvement in healing rates for established nonunions treated with CC stimulation (6 of 10 healed) compared to a placebo control (0 of 11 healed).3 Benazzo and colleagues reported an 88% success rate in treatment of stress fractures of the lower extremity in 25 athletes with electrical bone stimulation for an average of 52 days.4

Several authors have noted the importance of dose-dependent therapy, with some controversy concerning the optimal amount of treatment. Brighton and colleagues have suggested that the response to electrical stimulation probably involves several cell types in multiple stages of the cell cycle. Therefore, to provide maximum bone stimulation, they recommend maximum use of the electrical system when applying electrical stimulation to a fracture or fusion site.

A Case Example

Figure 2: Repeat radiograph after 14 weeks of capacitive coupling electrical stimulation demonstrates fracture union.

A 16-year-old high school basketball player presented with an acute injury to the right foot during a basketball game. The patient noted a 5-month history of lateral foot pain prior to the acute injury. Radiographs demonstrated a stress fracture of the fifth metatarsal shaft (Jones fracture) (Figure 1). He was counseled concerning the uncertain natural history of fracture healing, with the possible need for surgical fixation. The patient elected to attempt nonsurgical treatment and was placed in a non-weight-bearing cast with capacitive coupling electrical bone stimulation. Repeat radiographs after 14 weeks of electrical treatment demonstrated successful treatment with a healed fracture (Figure 2), and the patient returned to full activity without pain.

Conclusion

Electrical stimulation has been documented to be useful for the treatment of difficult fractures, delayed, and nonunions, and stress fractures in athletes. Several methods of applying electrical current to the target site are available. Direct current units are invasive (implanted at the target site), but alleviate concerns about patient compliance. The physician may choose external, noninvasive units based on fracture treatment site, unit size and stimulation method, and patient compliance. As a general rule, with electrical bone stimulation “more is better.”