Introduction: LIPUS can be used for fractures to promote bone healing. Established for non-union and delayed union fractures, it has the advantage of avoiding the risks associated with surgery and can speed up healing time.
LIPUS works by accelerating all the stages of bone healing. National institute of clinical excellence has evaluated LIPUS and recommended it for non-union, but rejected it for delayed union due to cost. Aim of this review is to look at the latest evidence regarding LIPUS.
Pubmed and Scopus were searched for relevant articles on LIPUS and bone healing since 2008. Four relevant articles were found which were reviewed and analysed.
Discussion: There is benefit in using LIPUS for non-unions and delayed unions and a potential benefit in sepsis. No benefit for LIPUS was found in fresh clavicle fractures or for surgically treated fractures of the lower extremity. There is a potential benefit for LIPUS in comminuted fractures.
Conclusion: LIPUS is useful in non-union and delayed union fractures. Effectiveness in fresh fractures possibly depends on fracture site but further research is needed. LIPUS may have a role in comminuted fractures but further robust research is needed in this subject.
Griffin, X.L., et al., Ultrasound and shockwave therapy for acute fractures in adults. Cochrane database of systematic reviews (Online), 2012. 2.
excellence, N.i.f.c. EXOGEN ultrasound bone healing system for long bone fractures with non-union or delayed healing. Technology guidance, 2013. 12.
Pounder, N.M. and A.J. Harrison, Low intensity pulsed ultrasound for fracture healing: a review of the clinical evidence and the associated biological mechanism of action. Ultrasonics, 2008. 48(4): p. 330-8.
Malizos, K.N., et al., Low-intensity pulsed ultrasound for bone healing: An overview. Injury, 2006. 37(1): p. S56-S62.
Behrens, S.B., M.E. Deren, and K.O. Monchik, A review of bone growth stimulation for fracture treatment. Current Orthopaedic Practice, 2013. 24(1): p. 84-91.
Siska, P.A., G.S. Gruen, and H.C. Pape, External adjuncts to enhance fracture healing: What is the role of ultrasound? Injury, 2008. 39(10): p. 1095-1105.
Hemery, X., et al., Low-intensity pulsed ultrasound for non-union treatment: A 14-case series evaluation. Orthopaedics and Traumatology: Surgery and Research, 2011. 97(1): p. 51-57.
Romano, C.L., D. Romano, and N. Logoluso, Low-Intensity Pulsed Ultrasound for the Treatment of Bone Delayed Union or Nonunion: A Review. Ultrasound in Medicine and Biology, 2009. 35(4): p. 529-536.
Schofer, M.D., et al., Improved healing response in delayed unions of the tibia with low-intensity pulsed ultrasound: results of a randomized sham-controlled trial. BMC Musculoskelet Disord, 2010. 11: p. 229.
Snyder, B.M., J. Conley, and K.J. Koval, Does low-intensity pulsed ultrasound reduce time to fracture healing? A meta-analysis. American journal of orthopedics (Belle Mead, N.J.), 2012. 41(2): p. E12-19.
Lubbert, P.H., et al., Low-intensity pulsed ultrasound (LIPUS) in fresh clavicle fractures: a multi-centre double blind randomised controlled trial. Injury, 2008. 39(12): p. 1444-52.
Lenza, M., et al., Conservative interventions for treating middle third clavicle fractures in adolescents and adults. Cochrane Database of Systematic Reviews, 2009(2).
Busse, J.W., et al., Low intensity pulsed ultrasonography for fractures: Systematic review of randomised controlled trials. BMJ (Online), 2009. 338(7695).
Kinami, Y., T. Noda, and T. Ozaki, Efficacy of low-intensity pulsed ultrasound treatment for surgically managed fresh diaphyseal fractures of the lower extremity: Multi-center retrospective cohort study. Journal of Orthopaedic Science, 2013. 18(3): p. 410-418.
Lerner, A., H. Stein, and M. Soudry, Compound high-energy limb fractures with delayed union: our experience with adjuvant ultrasound stimulation (exogen). Ultrasonics, 2004. 42(1–9): p. 915-917.
Leung, K.-S., et al., Complex tibial fracture outcomes following treatment with low-intensity pulsed ultrasound. Ultrasound in Medicine & Biology, 2004. 30(3): p. 389-395.
De Albornoz, P.M., et al., The evidence of low-intensity pulsed ultrasound for in vitro, animal and human fracture healing. British Medical Bulletin, 2011. 100(1): p. 39-57.
Most read articles by the same author(s)
- Mark Aziz, Should all Stents be Drug-Eluting Stents? , RA Journal Of Applied Research: Vol 5 No 03 (2019): VOLUME 05 ISSUE 03