Abstract
Background:
The Exogen Ultrasound Device is licensed for fracture non-union under NICE guideline MTG-12. Reimbursement is offered if there is no fracture union after 250 days of treatment as per manufacturer guidelines. Quoted healing rates vary between 62% and 100%: we compare our results to these.
Method:
A retrospective audit of all patients who received Exogen for long bone non-union was undertaken. The indication, duration of treatment, fracture outcome and compliance with the recommended treatment pathway were recorded.
Results:
41 patients (17M 24F) mean age 41yr were reviewed. There were 15 femoral, 22 tibial and 4 humeral non unions. 16 healed following a mean of 169 days of Exogen treatment (39%). 21 patients did not show any improvement in radiological/clinical union and required further surgery. 4 were not united after 250 days of Exogen treatment. No reimbursements were received.
Discussion:
Our results with Exogen differ from published studies with lower than expected healing rates. Failure to complete the recommended pathway however resulted in a breach of the reimbursement stipulations.
Conclusion:
Ongoing review of prescription and use of the Exogen device is required to ensure optimum patient outcomes. 250 days of treatment may not be required to determine failure to heal.
