• Neuromuscular Electrical Stimulation Enhances Fracture Healing

METHODS: The study protocol was approved and followed by the Institutional Animal Care and Use Committee of the author’s institution. Twentyfour rabbits received unilateral, transverse, mid-tibial, 3-mm gapped osteotomies that were stabilized with double-bar external fixators. With the aim to simulate the venous stasis and soft tissue edema that is common to acute tibial fractures, the left femoral vein was ligated in all animals. The animals were divided into two study groups: Animals in Group I (study group, n=11) received NMES, while animals in Group II (control group, n=13) did not receive any treatment. With all animals placed in hanging slings, and thirty minutes after administration of analgesia (Morphine, 5 mg/kg), only animals in Group I (study group) received one hour of daily NMES, starting on the fourth post-operative day, for a period of twenty-five days. For NMES, two surface electrodes (2-cm in diameter) were adhered to the shaved skin using elastic adhesive bandages and electrode cream: one above the patellar tendon and another around the lateral thigh. Electric current, with an approximate amplitude of 25 mA, a pulse width of 50 μsec, and a pulse rate of 4 Hz was applied using an EMS+2 Neuromuscular Stimulator (Rehabilicare, New Brighton, MN). The electrical stimulation was given in cycles of 20 seconds (a progressive increase in intensity for 5 seconds, peak intensity for 10 seconds, and a progressive decrease in intensity for 5 seconds) with resting intervals of 15 seconds.