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Objectives: To compare the effect of pulsed electromagnetic field (PEMF) extracorporeal shock wave therapy (ESWT) on healing of delayed as well as non-united tibial fractures.  Methods: This study was carried out on 60 adult patients suffering from delayed or non-union tibial fractures in spite of previous conservative treatment by (closed reduction and casting), or operative treatment by: ORIF by (IMN, plate and screws or gliding nail), or external fixation. They were divided according to line of treatment into 2 equal groups. The first group received (PEMF) therapy at the site of fracture of 12 Hz, 3 mT for 60 minutes per session, for 3 months, the patient of the second group were treated by focused (ESWT) at the site of fracture 3 sessions of 2500-3000 impulses each given at 0.25-0.84 mJ/mm2, at interval of 48-72 h between sessions, a maximum of 3 cycles of treatment was given at 3 months intervals. Clinical and radiological assessments were done before, after and then 6 months later as follow up. However functional assessment was done after treatment and 6 months later as follow up.  Results: Our results showed better and earlier improvement of clinical, radiological as well as functional scores in group II more than group I.  Conclusion: The best significant as well as more rapid clinical, radiological and functional improvement in cases of delayed or non-united tibial fractures was obtained with ESWT compared to PEMF therapy.

Pulsed Electromagnetic Field and Extracorporeal Shock Wave in Treatment of Delayed or Non-United Tibial Fracture, A Comparative Study