How Can TCM and Acupuncture Treat Broken Bones?
TL;DR - Summary
I broke my big toe recently, check out the case report I wrote about how I treated it with TCM herbal medicine and acupuncture here.
Acupuncture and TCM herbal medicine treatment can start almost immediately after breaking a bone, with a few caveats.
These treatments are geared toward the principles of: relieve swelling, decreasing pain, improving circulation, and promoting the regeneration of bone and soft tissue.
Some studies indicate that acupuncture promotes a faster healing of the bones, greater improvements in range of motion, and earlier reductions in swelling and pain.
The English research (there is a lot more in Chinese/Korean) about acupuncture/TCM for fractures is poor due to many factors but practitioners anecdotally report that regular treatments during recovery reduces healing time.
Note: In this article I talk about a mix of Traditional Chinese Medicine (TCM) treatments and Western Medicine (WM) treatments for broken bones. In places where it might be ambiguous which approach I’m talking about, I use the abbreviations.
Allow Me To Set The Stage…
I experienced my very first bone break last November when I dropped a weight on my left big toe; because I really wanted to end 2021 with a bang, y’know? Broken bones are a significant injury, but most of the time a broken toe isn’t too much of a problem; our smaller toes can be braced so they don’t move around and, with some stiff shoes and a few activity modifications, will often heal without issue. My personal brand however is going above and beyond, so of course when I broke my big toe, I REALLY broke it.
Breaking a big toe is also more of an event than other toes because of it’s importance for balance and how we distribute weight through our feet as we walk. Poor big toe function can lead to a number of foot or ankle problems; walking can become uneven or choppy and our risk of falling increases. From the perspective of powerlifting (my main form of physical activity), a healthy big toe is key to distributing weight evenly through the foot for maximum force transfer and balance. Since I wanted to get back to throwing heavy weights around ASAP, treating myself using myself with acupuncture and herbal medicine seemed like the obvious thing to do.
“Fractures of any kind can be treated with TCM herbal medicines and acupuncture, many within three to five days of the initial injury. ”
Crushed into many pieces is actually more accurate; a 25lb plate weight will do that. [x-ray image of my broken toe]
A Primer On How Bones Heal
Bones heal in overlapping stages called the inflammatory, reparative, and remodeling stages (WM). Here’s a condensed version of what happens during each of these stages (1):
Inflammatory Stage: This begins almost immediately with a fracture. Blood rushes to the injured area and causes swelling that protects the tissues from moving and causing further damage. The body starts breaking down a small amount of bone around the lines of the break.
Reparative Stage: Hard tissue called a “callus” starts developing around the fracture. New blood vessels grow* like little roots all over the area and cartilage starts to form across the fracture lines. This stage ends when there is no more movement of the bone pieces on clinical examination, there is no pain at the site, and the body part can be used without pain.
Remodeling Stage: The callus that was originally made of cartilage starts to turn into bone (a process called ossification) and other small parts of the bone are broken down and rebuilt. This is the stage where you can gradually (and I mean GRADUALLY) return to moving the fractured part normally. Load bearing and other rehabilitative exercises come into play as we slowly retrain range of motion and strength.
* Keeping a fracture immobile during the first two stages is crucial for allowing these delicate new blood vessels to grow and deliver the materials our body needs to repair bone. This is where casts, braces and other immobilization methods are key.
There Are Different Approaches To Healing Fractures
Fractures of any kind can be treated with TCM herbal medicines and acupuncture, many within 3-5 days of the initial injury. Before that we’re waiting for a few things: The acute inflammatory process should settle down before we do any needling; Information from the Western Medicine side on what and how severe the injury is; The completion of emergency care like x-rays, assessment from a doctor or specialist, surgery if necessary, and appropriate prescription medications for pain management. Once those acute care steps are completed and we’re into the rest-and-let-it-heal part, we can start TCM treatment.
To treat a fracture, an Acupuncturist or TCM Practitioner will adjust the specifics of what they do depending on the stage of healing, the overall state of health in the body, and underlying constitutional factors. The key treatment principles for fractures are to relieve swelling, move/activate blood, eliminate pain, and promote the regeneration of bone and soft tissues; the goal being to speed up healing and improve the overall quality of recovery from the bone break. Done well, acupuncture may decrease the amount of time a fracture takes to heal by about a third (2). Acupuncture can also be effective for reducing pain and increasing the quality of recovery in the long run (3) ie. Decreasing the chances of chronic, recurring pain/weakness in that area, and enabling a faster return to normal activities.
The speed at which a bone heals depends on the type of fracture, the bone(s) that are involved, the age of the patient, and other coexisting disorders they have. In general, children heal much faster than adults and people without other pre-existing conditions will heal faster than people with disorders that impair circulation (diabetes, peripheral vascular disease) (4). Even with acupuncture, the treatment time for similar fractures can vary a lot (5), reflecting the fact that the overall state of health in someone's body has a huge impact on how quickly or slowly they may heal.
Types of fractures - I had a comminuted fracture.
What Does TCM Treatment For Fractures Look Like?
When treating a fracture from the perspective of TCM we’re aiming to encourage the body’s normal healing processes and to relieve as much discomfort for the patient as possible. Fractures cause local damage to the channels and collaterals that run through the body, leading to qi and blood stagnation and the accumulation of fluids in the area (inflammatory stage), both of which cause pain. To encourage healing, our first priority is reducing swelling and gently moving qi and blood - so we needle distal acupuncture points that regulate the entire affected channel and select herbal medicine to do the same. It’s also easier and much more comfortable for the patient to avoid needling too close to the injured site in the early stages of a fracture.
An acupuncture and moxibustion treatment on my broken toe.
As swelling and local pain decrease around the fracture area, we can start to needle closer to it to encourage blood flow and tissue repair, while adjusting our herbal formula to focus more on the regeneration of bone and muscle tissue. The points used in treatment will vary a lot depending on the fracture location and what the practitioner and patient decide together are the most important outcomes to focus on. For one person, reducing pain may be the most important measure, while sleep or dietary disturbances as a result of the injury may be more important for another. No one symptom is isolated from the body as a whole; to heal fractures well we must consider everything that is happening and balance the treatment to reflect where an individual’s body is at and what it needs most.
During treatment the number of needles we use also varies a lot, but it’s often in the range of 10-20 total. Once they’re all in and the patient feels comfortable we allow the needles to sit for 25-30 minutes, or one full cycle of qi through the body, and then all the needles are removed.
A practitioner prescribing herbal medicine formulas will aim to relieve pain, reduce swelling, repair soft tissue and rebuild bone. There are many herbs we can use. If raw, individual herbs are available the formula can be customized to the patient's constitution and adjusted on a regular basis. If not, there are prepared formulas that we can take in liquid, powder, granule, or pill form.
“Acupuncture treatments done daily for 2 weeks post-fracture can significantly improve long term outcomes for patients... we should be more deeply investigating acupuncture as a powerful post-fracture care option.”
What The Research Says
Current, high quality research investigating the effect of acupuncture and herbal medicine on fractures seems to be fairly lacking, especially in English. And when I say lacking, I mean that there are simply not enough high quality studies to draw strong conclusions from. There are a few meta-analyses for articles published from 1993-2013 (6) and 2013-2021 (5) but both highlight the need for better study design and execution - like having larger sample sizes, including control groups, long-term follow-up, and direct comparisons with other conventional treatments. Designing research around STRICTA guidelines for reporting interventions in clinical trials of acupuncture (7) has been suggested as a good way of achieving better study quality (5).
An aside if you’re wondering why this is important: Science relies on consensus between many studies over time to draw meaningful, robust conclusions. That means one study showing positive or negative results from a certain treatment - like acupuncture and traditional chinese medicine - needs to have its conclusions retested and verified by multiple other researchers in order to determine if the results hold true or not. Unfortunately for folks in Canada and the US, there isn’t as much money going into Acupuncture and TCM research as there is in several Asian countries, so unless studies are translated into English we’re a little in the dark on certain specific topics like fractures.
However, I do want to talk about two studies (their summaries can be found here) from 2018 that both showed acupuncture provided significant improvements to speed and quality of healing in cases of tibiofibular and humeral fractures, over non-acupuncture control groups (14)(15). I couldn’t find original copies of either study in English so I assume they were only published in Chinese or are not available online.
Study 1
Severe tibiofibular fractures that required internal fixation surgery (metal rod and screws inserted to hold bones in place)
94 patients, split into an acupuncture group and a control group; both groups were statistically similar in terms of baseline characteristics
Both groups were prescribed functional rehabilitation exercises
The control group received Jie Gu Qi Li Pian (bone setting pills) in a 1.5g dose, twice daily, for a total of 60 days
The acupuncture group patients were all needled with the same points which were retained for 30 minutes; daily treatments for seven days (equalling “one course”) followed by a three day pause, after which a second course was given; 14 treatments total
60 days post-surgery the outcomes were:
Control group:
22 participants were classified as fully healed, 16 were partially healed, and 9 were unhealed - total effective rate 80.9%
Acupuncture group:
32 participants were classified as fully healed, 13 were partially healed, and 2 were unhealed - total effective rate was 95.7%
Study 2
Supracondylar fractures of the humerus
64 patients, randomly assigned to the acupuncture group or the control group
Both groups were given standard treatments for fractures: surgery or manipulations to reposition the bones, support with a splint or plaster cast
Both groups were prescribed Xue Sai Tong intravenous fluid (TCM herbal medicine) administered daily for 14 days, 0.2g dose
The control group received no other treatment
The acupuncture group patients were all needled with the same points which were retained for 30 minutes; daily treatments for 14 days
Outcomes were assessed after 12 months
Based on Neer classification for humeral fractures (score out of 100): The acupuncture group scored consistently higher across all areas with a total score of 88.2, compared with 80.09 in the control group.
Based on the participants’ clinical characteristics following the study:
Control group: 9 participants classified as excellent, 16 as good, 5 as satisfactory, and 2 as unsatisfactory.
Acupuncture group: 18 participants in the excellent category, 11 were classified as good, 2 as satisfactory, and 1 as unsatisfactory
The “excellent” and “good” scores were added together to give the total effective rate - 90.62% for the acupuncture group compared with 78.13% in the control group
Both of the above studies found that acupuncture treatments done daily for 2 weeks post-fracture can significantly improve long term outcomes for patients with lower leg and upper arm fractures. That said, 94 and 64 patients in each respectively study isn’t a lot but it is a good indication that we should be more deeply investigating acupuncture as a powerful post-fracture care option.
Here are some of the highlights from other studies about acupuncture and TCM herbal medicines for broken bones:
People who used TCM treatment for their fractures (in Taiwan) spent less money on hospital care than those who did not (8).
Acupuncture done on rats (in Turkey) benefited overall healing by improving callus development as well as bone mineralization and density measurements. Compared with rats in the control group, the acupuncture group also showed more improvement on x-rays. The researchers suggested further studies in clinical practice to determine how these changes manifest in humans (9).
In two cases of non-operative fracture cases, a male patient, 77, and female patient, 88, experienced better pain management and healing times significantly shorter than average (with treatment 2-4x/week) (10).
In 50 patients with osteoporotic fractures of either their hip bones or vertebrae, patients receiving acupuncture in addition to medication saw swelling and tenderness decrease significantly faster and callus growth and bone mineral density were more improved compared with the medication only group (11).
So while we do need more data about acupuncture and TCM for fractures, the studies currently available trend in a positive direction. I think that’s enough of an argument for North American governments and medical institutions to put more money into large-scale trials for people with broken bones. As a low risk, low side effect treatment option, acupuncture could be an excellent addition to future fracture recovery protocols.
“Acupuncture [on rats] benefited overall healing by improving callus development as well as bone mineralization and density measurements... Compared with the control group [they] also showed more improvement on x-rays.”
Case Study
I will always be my own guinea pig
I absolutely wrote up a whole case study about what TCM treatment I used for my broken toe! How could I not? If you’re interested in the details or just want to see more super cool x-ray pictures of a smushed big toe bone, you can find it all in my article: Traditional Chinese Medicine Case Report: Broken Big Toe.
Break A Leg?
As a practitioner of Traditional Chinese Medicine, I look to acupuncture, herbal medicine, moxibustion, and other TCM modalities for help with my own injuries or health disruptions. Many times it’s the day-to-day imbalances that eventually lead to larger health concerns and if we address these sooner, it is easier to prevent chronic issues and to maintain quality of life.
There are also situations when seeing our family doctors or medical specialists is important. They have access to diagnostic tools and treatments that provide different insight and care than what TCM can. In the case of broken bones, WM is hugely important at the beginning to reduce pain, put bones back into good position, and to manage other things that accompany intense traumatic injury. Once these are taken care of however, there are TCM options that can help us heal faster, better, and sometimes with fewer side effects than just sticking to conventional treatments alone.
Whether it’s an acute injury like a broken bone, an old injury that didn’t heal well, or another internal health concern you need help with, email me and let’s chat about how I can help.
Thanks for reading! For more information about Traditional Chinese Medicine treatments
check out my other blog articles or my Instagram @alina.acupuncture
BONUS STUFF: Research Article Summaries
If you want to dig into the research a little more, I summarized several papers about Traditional Chinese Medicine for fractures below. Here are a few important notes about this section:
I am not currently a researcher, so my ability to evaluate the quality of each of these studies is limited by not being directly involved in academia anymore.
Many of these studies require a lot of specific knowledge about acupuncture, physiological mechanisms of healing, and research protocols to understand what they’re saying in a useful way. Understanding the nuance of this jargon is difficult unless we have recent academic training. I’ve tried to translate that kind of stuff as best I can without oversimplifying the conclusions.
Some of these texts are only available in Chinese or Korean. For those, I relied on Google Translate to read them which invites a host of translation issues. Be aware of this if you are going to read the original article.
For some I could only find abstracts, which makes nuances in the study impossible to understand.
Citations for each study are at the very end if you want read any in full.
A Review of Case Reports on the Application of Acupuncture as a Treatment for Fracture since 2013 (5)
*only English abstract, Google translated version available (not great)
A review of 33 case reports for fractures treated with acupuncture to find trends in treatment and evaluate the quality of the case reports (as opposed to necessarily determining overall efficacy of acupuncture treatment for fractures). The case reports were classified based on location of the fracture, frequency of acupuncture, meridians, treatment period, and other treatment variants. They also assessed the quality of the reports based on the STRICTA guidelines for reporting interventions in clinical trials of acupuncture. This review summarized the various techniques, acupuncture points, and reporting methods used in articles about acupuncture for fractures, but did not evaluate efficacy of TCM treatment. Some key takeaways: 1. They found that treatment time varied significantly, even for fractures at similar sites, reflecting the fact that fracture healing varies widely according to the patient's condition, degree of injury, and other accompanying treatments. 2. Over half of the case reports did not meet STRICTA guidelines, signaling a need for better overall reporting of case design when using acupuncture treatment protocols.
Reviewing Research on the Treatment and Study of Fracture in Korean Journals Objective - Focus on Domestic Thesis (6)
This study is similar to the previous one except it looked at studies from 1993-2013 to highlight treatment trends. They found 38 studies total: 8 experimental reports, 20 case reports and 10 retrospective reports. They broadly concluded that (Korean medicine) acupuncture was effective for the treatment of fractures, but don’t provide any good qualifiers for what that means. They also highlight the need for more and better study of acupuncture for fractures.
The Use of Acupuncture in the Management of Patients With Humeral Fractures: A Systematic Review and Meta-analysis (3)
This review included only randomized controlled trials comparing acupuncture treatment (of any kind) with non-acupuncture treatment for humeral fractures only. From the inception of the databases searched to 2020, only 7 studies were included in the review and of those, only two included in the metaanalysis. The main outcome being compared in these trials was pain which was quantified using the international standard for all types of pain: the visual-analogue scale or VAS. Their conclusions were that acupuncture for humeral fractures can be effective for reducing pain and increasing the quality of recovery in the long run for upper arm fracture. However, most of the studies included had a high risk of bias, the measurement tools they used were highly variable, and the specific acupuncture treatments were very different making it hard to compare the results across studies. The authors also state that the conclusion of this review should be cautiously interpreted in clinical practice due to the ambiguous quality of the included studies.
Acupuncture combined with multidisciplinary care for recovery after traumatic multiple rib fractures: a prospective feasibility cohort study (12)
This study followed twenty patients with traumatic multiple rib fractures who were admitted to a regional trauma centre in South Korea. A combination of acupuncture and multidisciplinary inpatient management was used initially, with an additional 3 months of outpatient acupuncture treatment. At the outset of the study 95% of patients reported above-moderate levels of pain, which decreased to 41% at the 6 month check-in. While overall quality of life appeared to deteriorate over the 6 month period for most participants due to the rib fractures, 94% still reported slight or considerable improvement from treatment.
Overall, this doesn’t give us a whole lot of information about significant potential benefits of acupuncture for fracture care because there is no control group to compare it with.
Prescription patterns of Chinese herbal products for patients with fractures in Taiwan: A nationwide population-based study (8)
This study looked at the types of TCM herbal formulas that are typically being used in practice for fracture healing in Taiwan, where TCM is widely used. As opposed to a clinical trial, this study was more about data collection. In a random sample of one million patients (the data were from the National Health Insurance Program), 112,327 (about 11%) had a fracture diagnosis, and of those 5731 (almost 5%) used TCM to help with their healing.
The results may be of interest to any TCMPs reading this; here’s a list of the top formulas used for fractures:
Shu Jing Huo Xue Tang (Relax the Channels and Invigorate the Blood Decoction) in 11.3% of cases
Zheng Gu Zi Jin Tang (Bone-Setter's Purple–Gold Special Pill) in 9.7% of cases
Shao Yao Gan Cao Tang (Peony and Licorice Decoction) in 3.5%of cases
In terms of the top individual herbs used Rhizoma Drynariae (Gu Sui Bu) appeared to be the most frequently prescribed herb at 7.0%, followed by Radix Dipsaci (Xu Duan) at 6.6% and Rhizoma Corydalis Yanhusuo (Yan Hu Suo) at 3.8%. They also found that compared with other fracture patients, TCM users had lower medical expenditure for hospitalization within the first six months after their initial fractures. For those looking for more information on specific herbs related to fracture treatment, this could be a useful starting point.
Effect of acupuncture therapy on fracture healing in rats with femur fractures (9)
This study out of Turkey determined that acupuncture is beneficial for fracture healing, specifically in the initial stages of a femur fracture. Researchers found that acupuncture (performed 4 sessions per week at sides both distal and local to the fracture) helped suppress the effects of oxygen free radicals and regulate antioxidant enzyme activity, thus improving healing. They found acupuncture improved callus development as well as bone mineralization and density measurements. Compared with rats in the control group, the acupuncture group also showed more improvement on radiographic imaging (x-rays). They suggest further studies in clinical practice to determine how these changes manifest in humans.
Clinical study on abdominal acupuncture for osteoporotic vertebral compression fracture (13)
This study took 45 patients with osteoporotic vertebral compression fractures and divided them into abdominal acupuncture, body acupuncture, and medication groups, 15 people each. All groups received the same medication protocol. The abdominal acupuncture group was treated with RN-12 (Zhongwan), RN-10 (Xiawan), RN-6 (Qihai), RN-4 (Guanyuan), RN-9 (Shuifen), and ST-24 (Huaroumen), while the body acupuncture group was treated with Jiaji points superior and inferior to the affected area, ashi points (painful points), UN-40 (Weizhong), and UB-57 (Chengshan). In both acupuncture groups, treatment was given 1x/day, 6 days/week, for 3 weeks in total. Changes were evaluated in all groups before treatments began and at 1, 2, and 3 weeks using visual analogue scale (VAS) and Barthel index (BI) to evaluate pain degree and activities of daily living.
Note: Visual analogue scales (VAS) are psychometric measuring instruments designed to document the characteristics of disease-related symptom severity in individual patients and use this to achieve a rapid (statistically measurable and reproducible) classification of symptom severity and disease control. VAS can also be used in routine patient history taking and to monitor the course of a chronic disease such as allergic rhinitis (AR). The Barthel Scale/Index (BI) is an ordinal scale used to measure performance in activities of daily living (ADL). Ten variables describing ADL and mobility are scored, a higher number being a reflection of greater ability to function independently following hospital discharge.Time taken and physical assistance required to perform each item are used in determining the assigned value of each item. The Barthel Index measures the degree of assistance required by an individual on 10 items of mobility and self care ADL.
The researchers found that patients in the two acupuncture groups reported better VAS and BI scores after 1 and 2 weeks than the medication only group. The results at 3 weeks were similar, although the abdominal acupuncture group reported better BI scores than the body acupuncture group.
Traditional Chinese medicine speeds-up humerus fracture healing: Two case reports (10)
Two patients, a 77 year old male and 88 year old female both with a history of hypertension, had proximal humeral (upper arm bone) fractures and declined surgical interventions. After being transferred to the TCM ward of the hospital, both were treated instead with similar acupuncture treatments on LI4, LI10, LI1, LI15, LI16 and SI9, occasional electroacupuncture at LI4 and LI16 in addition on the herbal formula Zhèng Gŭ Zĭ Jīn Dān (for qi and blood stagnation in later stages of healing from traumatic injuries). The male patient underwent 11 treatments in 7 weeks, while the female underwent 18 over 4 weeks.
Compared with similarly aged patients with the same type of fracture and non-operative treatments, the healing time of these two cases was significantly shorter than average. The authors concluded that TCM treatment (acupuncture and herbal medicine) could speed up fracture healing while also playing a role in pain management. They also noted the need for long-term follow-up for these types of fracture treatments, and more studies to determine how effective TCM treatment for elderly bone fracture could be as there is still little available research.
Effect of acupuncture on union of osteoportic fracture (11)
I wasn’t able to find a full English version of this article but here’s my interpretation of the available English abstract:
This study looked at 50 patients with osteoporotic fractures of either their hip bones or vertebrae. Patients were divided into two groups: The first was treated with medication only, the other with medication plus acupuncture. The acupuncture treatment focused on strengthening the spleen, reinforcing the kidney, warming the meridians and activating the collaterals.
Researchers stated that the group receiving acupuncture improved faster overall - swelling and tenderness decreased significantly faster and callus growth and bone mineral density were more improved compared with the medication only group. They concluded that the addition of acupuncture to treatment could accelerate the healing of osteoporotic fractures.
Works Cited
Campagne D. Overview of Fractures. Merck Manuals Professional Edition. Published January 2021. Accessed November 2, 2021. https://www.merckmanuals.com/en-ca/professional/injuries-poisoning/fractures/overview-of-fractures
Fitzpatrick D. Foot Acupuncture: Fractured Feet, Broken Ankle, Injured Toes. Alternative Foot Solutions. Published January 5, 2005. Accessed November 1, 2021. https://alternativefootsolutions.com.au/blog/acupunture-for-a-speedy-fix/
Chang H, Lee H, Kim H, Chung W-S. The Use of Acupuncture in the Management of Patients With Humeral Fractures: A Systematic Review and Meta-analysis. Journal of Manipulative and Physiological Therapeutics. 2021;44(2):146-153. doi:10.1016/j.jmpt.2020.09.001
Sheen JR, Garla VV. Fracture Healing Overview. PubMed. Published May 2021. Accessed November 10, 2021. https://www.ncbi.nlm.nih.gov/books/NBK551678/
Paik S-W, Nam K-H, Choi S-K, Lee J-H, Han Y-H. A Review of Case Reports on the Application of Acupuncture as a Treatment for Fracture since 2013. Journal of Korean Medicine Rehabilitation. 2021;31(4):49-63. doi:10.18325/jkmr.2021.31.4.49
Bae K-J, Jeong J-W, Jung M-Y, Kim S-J. Reviewing Research on the Treatment and Study of Fracture in Korean Journals Objective - Focus on Domestic Thesis. Journal of Korean Medicine Rehabilitation. 2015;25(3):27-36. doi:10.18325/jkmr.2015.25.3.27
MacPherson H, Altman DG, Hammerschlag R, Youping L, Taixiang W, White A, Moher D; STRICTA Revision Group. Revised STandards for Reporting Interventions inClinical Trials of Acupuncture (STRICTA): extending the CONSORT statement. PLoS Med. 2010 Jun 8;7(6):e1000261. https://stricta.info/wp-content/uploads/2021/04/STRICTA-2010-Checklist.pdf
Liao H-H, Yeh C-C, Lin C-C, et al. Prescription patterns of Chinese herbal products for patients with fractures in Taiwan: A nationwide population-based study. Journal of Ethnopharmacology. 2015;173:11-19. doi:10.1016/j.jep.2015.07.014
Seval Y, Emre K, Erhan Y, Ahmet K, Suleyman G, Mustafa O. Effect of acupuncture therapy on fracture healing in rats with femur fractures. Journal of Traditional Chinese Medicine = Chung I Tsa Chih Ying Wen Pan. 2020;40(2):275-283. Accessed January 22, 2022. https://pubmed.ncbi.nlm.nih.gov/32242393/
Hsueh T-P, Chiu HE. Traditional Chinese medicine speeds-up humerus fracture healing: Two case reports. Complementary Therapies in Medicine. 2012;20(6):431-433. doi:10.1016/j.ctim.2012.08.002
Su E, Mei T, Li G. Effect of acupuncture on union of osteoportic fracture. Chinese Journal of Osteoporosis. Published online 2003. Accessed January 22, 2022. https://en.cnki.com.cn/Article_en/CJFDTotal-ZGZS200303018.htm
Kim KH, Lee CK, Cho HM, et al. Acupuncture combined with multidisciplinary care for recovery after traumatic multiple rib fractures: a prospective feasibility cohort study. Acupuncture in Medicine: Journal of the British Medical Acupuncture Society. 2021;39(6):603-611. doi:10.1177/09645284211009539
Zhang W, Qiu X, Wang J. Clinical study on abdominal acupuncture for osteoporotic vertebral compression fracture. Journal of Acupuncture and Tuina Science. 2015;13(4):255-259. doi:10.1007/s11726-015-0863-5
Peng Zhen, Jiang Zelong, Teng Ning (2018) “Effect of Acupuncture on Rehabilitation of patients with Tibiofibular Fracture Undergoing Internal Fixation.” Chinese Journal of integrative Medicine Vol. 22 (26), pp. 3717-3718.
Liu Guanglin, Fu Jingdong, Wang Yan (2018) “Clinical Role of Acupuncture Combined with Xuesaitong in the Treatment of Supracondylar Fracture of the Humerus.” Chinese Journal of integrative Medicine Vol. 22 (26), pp. 3719-3720.