Abstract
Background
Fracture non-union is still a major challenge to the orthopaedic surgeon and established non-union has zero probability of achieving union without intervention.
Aim
The purpose of this study was to evaluate the effect of low intensity ultrasound for the treatment of established long bone non-union.
Methods
The study was done retrospectively. The case notes of all the patients who were treated by low intensity ultrasound therapy for a period of four years were used for data collection. The radiographs were reviewed to determine that the healing process had not progressed for a minimum of three months before start of low intensity ultrasound treatment. There were 11 patients who met the inclusion criteria of which 9 were male and the rest female (mean age of 50.1 years, range 27-74 years).
Results
There were seven closed and four open fractures. The fractured bones included seven tibias, two humerus and two femur. The initial treatment was varied and included surgical treatment (ORIF – 1, IM nailing – 4, External fixation – 3) in 8 patients and conservative treatment (MUA+ POP) in 3 patients. The average time to commencement of ultrasound treatment after the initial fracture was 38 weeks (range 20-72 weeks). All patients were compliant with the use of the device and no side effects were recorded. Bony union was achieved in 8 out of 11 patients (73%). The average time to healing was 27 weeks (range 12 to 48 weeks). The fractures that healed successfully were 6 tibias, one femur and one humerus, and included two infected non-unions.
Conclusion
This study shows low intensity ultrasound is an effective way of treating established long bone non-unions particularly tibial non-unions.
