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Exogen is a nightmare for the patient to use.  Cut hole in cast and compromise strength of cast exactly over the spot that needs to be the strongest, fill with gel and place the magic cap in the hole for 20 minutes.  Please.  Casts begin to stink, soft tissue swells up inside the "window" and if you are not exacatly on the fracture you are not treating anything.  Why are they only approved for distal tibia and distal radius?  Because those are two of the most subcutaneous areas on the skeleton.  Where are the double blind, US based studies on long bone nonunions?  They don't exist.  How did the study turn out with the use of internal fixation (locked tibial rod)?  ZERO success rate.  EBI is the gold standard.