Enumerate modalities leading to biological enhancement of fracture healing - This is a routine DNB Theory Question and often asked in Short Cases of Non Union in Practicals.
1.PEMF ( Pulsed Electromagnetic Fields ) : It is based on the discovery of electrical currents in bone that were generated in response to normal functioning mechanical loads. The PEMF’s are induced by a Square Wave Generator ( Faraday’s Law ). Optimal Frequency for Bone Growth : 15-30 Hz
2.Ultrasound : Accelerates Fracture Healing with short ( 15-20 minute ) daily treatment at 30 mW/cm2
3.Bone Marrow Injections ( Application of 20 ml of marrow harvested from iliac crest or greater trochanter for non unions < 5 mm )
4.Stem Cell Injection ( 100-150 ml bone marrow centrifuged to produce 2-4 ml aspirate containing multipotent marrow cells and osteogenic stromal cells )
5.Platelet rich plasma and related peripheral blood concentrates