28 patients (30 fractures) with open tibial fractures or high-energy-induced complex tibial fractures were randomized after surgery to undergo low-intensity pulsed ultrasound (LIPUS) stimulation therapy or sham treatment. The purpose was to compare short-term clinical and radiological outcomes between groups. Patients treated with LIPUS had significantly earlier tenderness relief, full weight-bearing, external fixator removal, and appearance of bridging bone calluses. Additionally, LIPUS achieved a significantly higher percentage change in bone mineral content and plasma bone-specific phosphatase activity at various follow-up time points.