Original contributionComplex tibial fracture outcomes following treatment with low-intensity pulsed ultrasound
Section snippets
Introduction and literature
Low-intensity pulsed ultrasound (LIPUS) is a fracture-enhancement technique that has been shown to improve fracture healing in acute fractures (Busse et al., 2002, Cook et al., 1997, Duarte, 1983, Hadjiargyrou et al., 1998, Heckman et al., 1994, Kristiansen et al., 1997, Nolte et al., 2001, Pilla et al., 1990, Tsai et al., 1992, Xavier and Duarte, 1983). Most of the clinical studies focused on simple and closed fractures. There were, however, very few studies on fractures with potential
Patients recruitment
From September 1999 through April 2002, patients with open tibial fractures and high-energy-induced complex tibial fractures that included comminuted and segmental fractures were recruited in the study. The inclusion criteria were all comminution and open fractures at the tibial shaft, and the exclusion criteria were simple fractures or fractures at other sites. Written consent was obtained from all patients before the start of treatment. The study protocol was approved by the Clinical Research
Patient information
A total of 28 patients, 25 men and 3 women, with ages ranging from 22 to 61 years old (average 35.3 years) were recruited in this study. Of these, 4 patients had segmental fractures and, thus, a total of 30 fractures were studied. The fracture patterns are shown in Table 1.
The distribution of the LIPUS-treated and the control groups is shown in Table 2; 15 patients (16 fractures) were treated by LIPUS, and 13 (14 fractures) were treated with a dummy machine. The methods of surgical treatment
Discussion and summary
The results of this clinical study show that LIPUS enhances fracture healing in open fractures and high-energy-induced tibial fractures. The study was well controlled, in which the patients could not distinguish the difference between the US machines and the dummy machines. The clinical examination and the radiological assessment were also done by clinicians without knowing the application of US on the patients. The surgical treatment of the fractures was done according to the clinical
Acknowledgements
Low-intensity pulsed US machines were sponsored by Exogen, Smith & Nephew, Inc. This study was supported by the earmarked grant from the Hong Kong Research Grant Council (RGC reference no: CUHK 4257/99M).
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