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C. Andrew L. Bassett, MD, ScD; Sharon N. Mitchell, RN; Sawnie R. Gaston, MD
College of Physicians and Surgeons of Columbia University New York

JAMA. 1982;248(8):921.

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In Reply.—

Dr Irvine is quite correct in pointing out that a significant number of fractures with delayed union may heal spontaneously. It was precisely for this reason that we subdivided our patient analysis into three categories; namely, less than nine months, nine to 24 months, and more than 24 months after fracture. The latter subgroup consisted of 332 patients with an average disability time of 4.7 years (range, two to 22 years). Such persons cannot be classed, reasonably, as having delayed union, particularly since an average of 3.4 operations per patient had failed to secure union before pulsing electromagnetic field (PEMF) treatment. These operations included most surgical procedures commonly used to treat nonunions. Furthermore, more than a third of these disabled individuals had been or were actively infected. In 29%, at least one recommendation for amputation had been made by an orthopedic surgeon. When 75% of such fractures are . . . [Full Text PDF of this Article]

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