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Radius shaft fracture
7%
240/3381
Distal radius fracture
10%
347/3381
Tibia shaft fracture treated with casting
11%
360/3381
Tibia shaft fracture treated with reamed intramedullary nailing
51%
1724/3381
Scaphoid fracture
21%
699/3381
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Tibia shaft fractures treated with reamed intramedullary nailing do not have Level 1 evidence supporting adjunctive LIPUS treatment. Low-intensity pulsed ultrasound (LIPUS) "bone stimulators" deliver 30mW/cm2 pulsed-waves via an external device over the fracture site. The meta-analysis by Busse et al found 6 randomized, controlled trials evaluating LIPUS. They concluded that low-intensity pulsed ultrasound treatment may significantly reduce the time to fracture healing for fractures treated nonoperatively. The metanalysis cites that Emami et al found no benefit to LIPUS treatment on intramedullary fixed tibial fractures. Injuries described in the metaanalysis as having positive benefits from LIPUS include radius shaft(Cook et al), distal radius(Kristiansen et al), scaphoid(Mayr et al), and tibia treated with casting (Heckman et al). The Level 1 study by Heckman et al of 67 patients found a significant decrease in the time to clinical healing in tibia fractures treated with casting and no serious complications with its use.
1.8
(80)
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