Electric Healing

Batteries for bone breaks

When Emanuel Brachfield's broken tibia failed to heal after six months in a cast and several operations, even his doctors began to worry. Reason: if fractured bones do not knit, the affected limb may eventually have to be amputated. Brachfield, 70, a retired New York City office worker, had heard from his physician that doctors at Manhattan's Columbia-Presbyterian Medical Center were experimenting with a treatment that uses electricity to mend broken bones. He tried it. After eight weeks of electrotherapy, Brachfield has shed cast and crutches and is walking normally again.

Medical researchers have long suspected that electricity can stimulate bone growth. But it was not until 1970 that Dr. Carl Brighton and his colleagues at the University of Pennsylvania School of Medicine actually showed that a small direct current could help mend patients' stubborn fractures. Today several dozen hospitals in the U.S. and abroad are using electrical treatment on orthopedic patients for whom other therapies have failed. Says Dr. C. Andrew Bassett, chief of Columbia-Presbyterian's orthopedic research labs: "No question about it. In these cases, electricity can significantly speed up the healing process."

Why it does remains something of a puzzle, but apparently the electricity acts as a kind of signal to certain bone cells known as osteoblasts. Normally, the cells promote deposition of calcium and other minerals that act as the "cement" in the formation of hard bone. Sometimes the osteoblasts go berserk, producing either too little or too much cement. When that happens, explains Bassett, "we can say, 'Release calcium,' or we can say, 'Don't release calcium,' simply by inducing a current with the necessary voltage across the cell membrane."

Electrotherapy is not necessary or even desirable for most fractures. "Natural healing is still the best," says Bassett, who notes that he and his colleagues are not in business to put careless skiers back on the slopes overnight. But electrotherapy can aid patients with nonhealing fractures--notably elderly patients and youngsters with congenital pseudoarthrosis of the tibia, an inherited condition in which nerve defects block healing of fractured shin bones.

In the technique devised by Brighton, Teflon-coated electrodes are implanted directly into the bone around the fracture site even before the broken limb is placed in a cast. The electrodes are then hooked up to a small 7.5-volt battery that is strapped to the cast; a tiny current of 10 to 20 microamperes is directed into the area of the break. The voltage is applied about twelve hours a day for two to four months. Then the electrodes are surgically removed.

Bassett has been able to avoid surgery entirely in some cases by resorting to a bit of electromagnetic prestidigitation. He attaches a set of electrical coils, like those in a small motor, on the outside of the cast directly around the region of the break. In that way he is able to induce an electrical current within the bone. The treatment requires only a 10-volt portable powerpack, can be operated by the patient at home, and is continued for about the same two to four months as Brighton's method.

Bassett reports solid bone growth in 80% of 308 patients; Brighton says that he has achieved an 84% cure rate in his 200 cases. Their patients have even more reason to be pleased. As his cast and magnetic coils were removed last month, Brachfield asked anxiously: "Can I play shuffleboard? Can I bowl?" Bassett hesitated a moment, looked at an X ray of the healed fracture, then confidently assured his patient that he would soon be playing both sports.

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