In their recent meta-analysis on the role of low-intensity pulsed ultrasound therapy on fracture healing,1 Jason Busse and colleagues conclude that treatment with low-intensity pulsed ultrasound could decrease disability associated with nonunion of fractures. However, the 3 studies investigated in depth2,3,4 reported principally on accelerated fracture union but did not report details of nonunion rates in the comparison groups.
Based on the evidence presented, it would be fair to conclude there is accelerated fracture healing. The case for reduction in fracture nonunion rates following low-intensity pulsed ultrasound therapy remains unproven.
M. McGavan McAlinden Consultant in Trauma and Orthopaedic Surgery The Ulster Hospital, Dundonald Belfast, UK
References
- 1.Busse JW, Bhandari M, Julkarni AV, Tunks E. The effect of low-intensity pulsed ultrasound therapy on time to fracture healing: a meta-analysis. CMAJ 2002;166(4):437-41. [PMC free article] [PubMed]
- 2.Heckman JD, Ryaby JP, McCabe J, Frey JJ, Kilcoyne RF. Acceleration of tibial fracture-healing by non-invasive low-intensity pulsed ultrasound. J Bone Joint Surg Am 1994;76:26-34. [DOI] [PubMed]
- 3.Kristiansen TK, Ryaby JP, McCabe J, Frey JJ, Roe LR. Accelerated healing of distal radial fractures with the use of specific, low-intensity ultrasound. J Bone Joint Surg Am 1997;79:961-73. [DOI] [PubMed]
- 4.Mayr E, Rudzki MM, Rudzki M, Borchardt B, Hausser H, Ruter A. Beschleunigt niedrig intensiver, gepulster Ultraschall die Heilung von Skaphoidfrakturen? Handchir Mikrochir Plast Chir 2000;32:115-22. [DOI] [PubMed]