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. 2023 Mar 3;2023(3):CD008579. doi: 10.1002/14651858.CD008579.pub4

Liu 2014.

Study characteristics
Methods RCT, parallel design.
Participants Setting: Institute of Shuguang Hospital Affiliated to Shanghai TCM University, Shanghai, China.
Study dates: October 2005 to March 2008.
Size: 81 participants in total, with 41 in treatment group and 40 in control group.
Baseline characteristics (intervention):

  • Age, mean (SD): 67.90 (± 5.58) years

  • Sex, M/F: 4/37

  • Fracture of processus styloideus ulnae: 24

  • Fractures involving radiocarpal articular surface: 19

  • Fractures involving distal ulnoradial joint: 21

  • Comminuted: 22

  • Lidstrom type: 

    • I: 12 

    • II: 4 

    • III: 8 

    • IV: 17


Baseline characteristics (control):

  • Age, mean (SD): 65.70 (± 6.09) years

  • Sex, M/F: 5/35

  • Fracture of processus styloideus ulnae: 21

  • Fractures involving radiocarpal articular surface: 21

  • Fractures involving distal ulnoradial joint: 19

  • Comminuted: 20

  • Lidstrom type:

    •  I: 8 

    • II: 6 

    • III: 12 

    • IV 14


Inclusion criteria: people with fractures involving radiocarpal joint or distal ulnoradial joint; people with fractures involving ulnar styloid process.
Exclusion criteria: Smith's or Barton's fracture; those with systemic disease.
Interventions General surgical details: all participants went under closed reduction and immobilised in a cast in the position of palmar flexion.
Intervention details: LIPUS was administered through a 2.5 cm diameter 'window' applied to the dorsal side of the fracture site for 15 minutes a day for at least 12 weeks. First administration was by doctors in hospital, and then it was self‐administered. 2 weeks later, participants were immobilised with below‐elbow plaster support.
Control details: immobilised with plaster support and cast until clinical union.
Outcomes Reported outcomes and time points
Follow‐up schedule: participants were followed up every week until union. Union was classified when participants could raise 1 kg levelly for 1 minute and faint fracture line on X‐ray.
Primary outcomes: time to fracture healing, degree of dorsal inclination, decrease of drift angle of ulna, and shortening of radius. 
Notes Funding: funding from the following sources: "National TCM Traumatology and Orthopedics Key Discipline, Shanghai Leading Talent Project, Key Project of Shanghai Science and Technology Commission, Shanghai Health Bureau in Pharmaceutical Research Special, The Shanghai TCM genre the Shi’s SHANGKE heritage base project."
Conflicts of Interest: study authors declare that they have no conflict of interest.
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Randomisation performed by random number table
Allocation concealment (selection bias) Unclear risk The method of allocation concealment is not reported
Blinding of participants and personnel (performance bias)
Objective measures High risk In the intervention group a "‘window’ of 2.5 cm in diameter was cut on the dorsal side of fracture site" and then treated in below‐elbow cast after 2 weeks. Whereas the control group were treated with plaster support and cast. Therefore blinding was not possible
Blinding of outcome assessment (detection bias)
Objective measures Low risk Outcome assessors were "blinded to treatment method"
Incomplete outcome data (attrition bias) Low risk All participants completed follow‐up and all outcomes fully reported
Selective reporting (reporting bias) Unclear risk No clinical trial registration or protocol available
Other bias Low risk No other risk of bias was identified