Ist niedrig-intensiver Ultraschall bei der Behandlung von Frakturheilungsstörungen wirksam?

Abstract

This prospective consecutive study judges the effectiveness of pulsed low-intensity ultrasound for treatment of boney healing disorders. 86 out of 100 treatments were successful. Although in these 100 cases 64 delayed unions and 36 nonunions were enrolled ultrasound therapy was performed as an alternative to the indicated operation in every case. Excluding ten cases of ununited fractures of the scaphoid no additional therapy was performed in any case. Stratifying the data no significant differences in healing rate and treatment time were observed between delayed unions and non-unions and between atrophic and hypertrophic healing disorders. Judging the healing rate of 86% one has to take into consideration that according to our in- and excluding criteria we had a preselected sample of patients. Nevertheless the effectiveness of pulsed low-intensity ultrasound for treatment of disorders of the fracture repair process is evident.

Healing of fracture nonunions treated with low-intensity pulsed ultrasound (LIPUS): A systematic review and meta-analysis

“…Of interest, patient age, patient gender, smoking habit, fracture age, and number of prior procedures had no impact on outcome. Moreover, it should be appreciated that PWSI !3 months was used as a prerequisite of eligibility, to avoid bias from concurrent use of surgery [4,25,[27][28][29][31][32][33][34]. This provides evidence that LIPUS can LIPUS was used as an adjunct to surgery in several studies reported here [9,26].…”

“…A total of 4611 references were evaluated ( Fig. 1) to yield 10 eligible references on LIPUS treatment of human fracture nonunions [4,9,[25][26][27][28][29][30][31][32]. Three references [33][34][35] were obtained outside the scope of the PubMed search, while 4608 references were found by PubMed.…”

“…Fifth, once an intervention is recognized as useful, there may be little impetus to characterize exactly how useful it is [42]. Mayr proposed a prospective, placebo-controlled trial of LIPUS but his proposal was rejected; study authors were forced instead to do a prospective, consecutive-observation study [25]. It is our hope that this meta- Although we performed a comprehensive search of published literature without language restrictions, we acknowledge that possible errors in search strategy and failure to include unpublished reports could have resulted in missing data.…”

Low-Intensity Amplitude Modulated Ultrasound Increases Osteoblastic Mineralization

“…8,9,15,16,26 Clinical studies also show faster healing rate with ultrasound stimulation. 6,10,11,14,20 In vivo studies show increased mechanical strength in bone tissues after ultrasound application in different stages of bone healing.…”

Niederenergetischer, gepulster Ultraschall zur Beeinflussung der Knochenregeneration

“…Durch die Anwendung von niederenergetischem, gepulstem Ultraschall konnte in klinischen und experimentellen Studien eine Verbesserung der Frakturheilung nachgewiesen werden [2,3,6,11,13,14,15,17]. Dabei konnte eine Verkürzung der Heilungszeit von bis zu 38% im Vergleich zu unbehandelten Patienten belegt werden.…”