Abstract
Objective: Under normal conditions, fractures can heal, but under some conditions, complications can occur, such as delayed union or nonunion. Interaction between the processes of angiogenesis and osteogenesis (the interaction of osteoblast and osteoclast) is the determining factor in the healing process. Exposure to an electromagnetic field, as a physical stimulus, affects osteogenesis both in the developmental stage of the embryo and in the fracture healing process. This study was conducted to determine the healing of delayed-union fractures through exposure to an extremely low-frequency-pulsed electromagnetic field (ELF-PEMF), comparing the failure load scores in experimental animals.
 Methods: The study was conducted in the Faculty of Medicine, Universitas Indonesia, with 56 experimental rats during August and September 2018.
 Results: There was a significant difference in the failure load score in both groups in the fourth and fifth weeks of the study. There were no differences in clinical improvement in the two groups.
 Conclusion: This study concluded that there was an improvement in delayed-union fracture healing after the administration of ELF-PEMF, as seen in the difference in failure load scores.
Highlights
Fracture is among the most common causes of injury in traffic accidents, mostly occurring in productive ages [1,2,3]
There was a significant difference in the failure load score in both groups in the fourth and fifth weeks of the study
This study concluded that there was an improvement in delayed-union fracture healing after the administration of ELF-PEMF, as seen in the difference in failure load scores
Summary
Fracture is among the most common causes of injury in traffic accidents, mostly occurring in productive ages [1,2,3]. A person has a 50% risk of a fracture during his or her lifetime [4]. About 9.1% of fractures in Indonesia are caused by traffic accidents [1]. Fractures heal normally, but some pathological healing processes can occur, such as nonunion or delayed union. Previous studies [5] have shown that the prevalence of nonunion and delayed-union fractures was 2.5% and 4.4%, respectively. In cases of open tibial fractures, a delayed union can occur in 31% of cases [5]. An abnormal healing process can cause various long-term problems, such as joint arthritis, decreased joint mobility, immobilization, prolonged treatment, and decreased quality of life in patients
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