N. Magida1, H. Myezwa2, W. Mudzi3, A. Khan4, E. Musenge5
1University of Pretoria, Physiotherapy Department, Pretoria, South Africa, 2University of the Witswatersrand, Physiotherapy Department, Johannesburg, South Africa, 3University of Free State, Post-Graduate Department, Bloemfontein, South Africa, 4Steve Biko Academic Hospital, Radiography Department, Pretoria, South Africa, 5University of the Witwatersrand, Department of Statistics, Johannesburg, South Africa
Background: Low-intensity pulsed ultrasound has the potential to increase the healing rate in lower limb fractures in patients who have been surgically treated.
Purpose: The objective of this study was to compare fracture healing in lower limb fractures in patients managed surgically and with LIPUS treatment compared to the patients managed surgically only.
Methods: Ninety-four patients with lower limb fractures were selected from two state hospitals and randomly assigned to a LIPUS intervention group and a control group. Patients were treated with LIPUS for 20 minutes every second day for 20 days during their hospital stay and after discharge. Pearson chi-square test was used to analyse changes in callus formation, cortical bridging, presence of the fracture gap and overall healing using per-protocol and intention to treat analysis at six, 12 and 18 weeks.
Results: The most prevalent fracture was on the femur in both the intervention (57.9%) and control (61.4%) groups. Per protocol, analysis indicated that there was no significant difference in the rate of callus formation, cortical bridging and the reduction of the fracture gap between the intervention and control group at six, 12 and 18 weeks with ITT analysis confirming these results. Approximately 10% to 20% of the intervention group had a higher percentage of callus formation at six weeks and better cortical bridging, and absence of the fracture gap at 12 and 18 weeks.
Conclusion(s): Low-intensity pulsed ultrasound did not enhance the formation of callus, cortical bridging and closing fracture gap. Low-intensity pulsed ultrasound is not recommended for treatment of fractures in general in any community, as the value of the machine and time is costly to the patient and the healthcare services if the patient does not present with non-union fracture.
Implications: LIPUS is not recommended to be used especially in poor developed countries.
Funding, acknowledgements: Mediotronics Physical Medicine for sponsoring the LIPUS machine for data collection.
Keywords: Low intensity pulsed ultrasound, fracture healing, Callus formation
Topic: Orthopaedics
Did this work require ethics approval? Yes
Institution: University of the Witswatersarnd
Committee: Wits Ethics Committee
Ethics number: M150236
All authors, affiliations and abstracts have been published as submitted.
