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Bone Fracture Healing

Many people throughout the world experience fractures that do not heal, despite the best of treatment. These fractures are said to represent non-union or delayed union. One method that can typically make this situation improve is low intensity pulsed ultrasound (LIPUS). LIPUS can accelerate bone healing, and greatly decreases the likelihood of problem fractures such as non-union and delayed union. The procedure has been well researched.

Below are the findings of some relevant studies using LIPUS treatment.

A study on fractures of the radius.

"Accelerated healing of distal radial fractures with the use of specific, low intensity-ultrasound: A multicentre, prospective, randomized, double-blind, placebo-controlled study."

Kristiansen, TK; Ryaby, BJP; et al.

The Journal of Bone and Joint Surgery 79-A(7) (1997):961-973)

Sixty patients were involved in this comprehensive research, having between them 61 fractures of the distal aspect of the radius (a forearm bone). 31 received sham (placebo) treatment, and 30 received actual LIPUS treatment. LIPUS treatments started within 7 days of injury.

One of the most important findings from this study was the time needed to achieve bone healing since the time of fracture. This could also be referred to as the time taken for union. Bone healing was defined as having occurred when the patient felt no pain or tenderness at the fracture site, and the fracture felt solid. It was simultaneously defined as x-ray examination revealing that there was complete bridging of the fracture.

The time needed for bone healing was much shorter in those receiving treatment (61 +/- 3 days versus 98 +/- 5 days). This represents a very large difference of approximately 37 days. As not every one heals at the same time, it is pertinent to note how many fractures were healed at different time periods after treatment commenced:

At 42 days after fracture, 20% (6 fractures) of those receiving actual treatment had healed compared with only 3% (one fracture) of those receiving sham treatment.

At 56 days after fracture, 50% (15 fractures) of those receiving actual treatment had healed compared with only 13% (4 fractures) of those receiving sham treatment.

Each stage of healing was also significantly accelerated. The time needed for an early x-ray visible sign of healing was, on average, 30 days +/- 1 day in those receiving actual LIPUS treatment. Whereas 39 days +/- 1 days in those receiving sham treatment.

All fractures that had received the LIPUS treatment had healed during the 16-week follow-up period. Five fractures that had received the sham treatment were still not healed by the end of the 16-week follow-up session.

A study on fractures of the fibula.

"Low-intensity pulsed ultrasound increases bone volume, osteoid thickness and mineral apposition rate in the area of fracture healing in patients with a delayed union of the osteotomized fibula".

Rutten, S; Nolte, PA; et al

Bone 43 (2008):348-354

This very detailed study was conducted on 13 patients, aged 42 to 63 years, with delayed union of the fibula. The fractures of the fibula had been deliberately produced during a surgical procedure carried out on the patients' knees. This fracturing of the fibula was a standard part of the necessary knee surgery, and was not carried out for any other reason. Only those fractures that had not been healed after 6 months took part in the study.The patients' fractures were treated for 2-4 months. It was a prospective randomised, double-blind, placebo-controlled study.

Seven patients received LIPUS treatment, and six received sham treatment. Their results revealed that those receiving LIPUS treatment had accelerated fracture healing of delayed unions of the fibula.

Concluding remarks:

Based on the above information, on average it would take about 30 days of LIPUS treatment before a patient could ascertain, by use of x-rays, if any early bone healing had occurred. After about 56 days, 50% of patients receiving LIPUS treatment could expect to have complete bone healing.

Our Brisbane clinics can structure LIPUS treatment for delayed union or non-union fractures in such a manner that you can receive LIPUS treatment over a 6 week period at a very affordable rate.

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