
General Orthopaedics
Variable evidence & efficacy of low intensity pulsed ultrasonography for fracture healing
BMJ. 2009 Feb 27;338:b35113 randomized controlled trials comparing low intensity pulsed ultrasonography to a control group, in patients with any fracture type, were included. The purpose of this systematic review and meta-analysis was to assess the efficacy of this treatment by systematically analyzing the available body of evidence. The pooled analysis across all trials (ie. all treatment inidications) displayed a significant reduction in radiographic healing time with low intensity pulsed ultrasonography compared to control. When treatment indications were assessed individually, LIPUS displayed accelerated functional improvements in operatively managed distraction osteogenesis and accelerated healing time in operatively managed non-union with bone-graft and non-operatively managed fresh fractures. Very low level evidence indicated the potenital for acceledrated healing in operatively treated fresh fractures. Overall, the results of this meta-analysis are conflicting and based on moderate to low-quality evidence. While the results show some promise for the use of low intensity pulsed ultrasound further high-quality trials are needed to identify the role it should play in different patient populations.
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