Title : Efficacy of bone healing stimulator ( Exogen ) on fracture non-union: A single centre experience
Abstract:
Background: Exogen treatment for fracture non-union has been practiced in our institute since 2015. According to the manufacturer, the healing rate following the use of Exogen is 86%. We conducted a study to assess the success rate and cost efficacy following the usage of Exogen for fracture non-union.
Methods: 30 patients with fracture non-union were provided with Exogen treatment at our institute since 2015. We reviewed the radiographs during the course treatment to assess for radiographic evidence of fracture healing. Patients were also assessed clinically on a regular basis.
Results: The median age of the patients was 52. 63% were female and 37% were male patients. Nearly 10% were diabetics, over 10% were on long term NSAID’s and just over a third were smokers. The majority, apart from two, had a closed fracture. 50% of patients had initial surgical fixation, In these patients Exogen treatment was started after a median of 7 months with a success rate of 72.2%, and the device was used for a median of 6 months in these patients. On the other hand, 50 % were started on the non-surgical treatment which continued for a median of 5 months, at which point Exogen treatment was commenced and 53.3% then united, with the median length of treatment 6 months.
Cost: The Exogen device is marketed at £ 2562 for each case which provides 8 months of treatment. This includes a performance guarantee enforced through 90% compliance and a minimum usage of 4 months in stable fractures. However, the treatment course does not include the fracture clinic visits cost.
Conclusion: Our union rate following the use of Exogen was 63.63%. Median length of treatment was 6 months in the union cases. Cases in which treatment failed the median treatment time was also 6 months. Our healing rate is lower than the published healing rate. This could be due to comorbidities and compliance. Overall, Exogen is a good treatment modality when other options fail. Further comparative study is required against non-union fractures managed conservatively.
