Low-Intensity Pulsed Ultrasound for Nonoperative Treatment of Scaphoid Nonunions: A Meta-Analysis

Abstract

While surgical intervention is still the standard, our results show that LIPUS may serve as a nonoperative alternative to scaphoid nonunion in certain cases. The results are encouraging in which these challenging fracture a nonunions can heal without further surgical intervention in the majority of patients.

Can low intensity pulsed ultrasound (LIPUS) be used as an alternative to revision surgery for patients with non-unions following fracture fixation?

“…12,28,29 Numerous systematic reviews and meta-analyses have found the success rate of LIPUS to range from 65 to 100%, with the average being above 80%. 14,30,31 However, contrary to published evidence, only 57.89% of patients (22 out of 38) in our study achieved a successful outcome following LIPUS treatment. Several patient and site-specific factors could account for this discrepancy.…”

Extracorporeal shockwave therapy for the treatment of scaphoid delayed union in a tennis player: A case report

“…Because 80% of the scaphoid is covered with cartilage and prevents callus formation, 5%–10% of fractures reportedly progress to pseudarthrosis without displacement. Delayed treatment has also been reported to increase the likelihood of non-union [5] . Surgical treatment is the gold standard for treating delayed scaphoid fracture union, and there are few reports of conservative treatment.…”

“…Surgical treatment is the gold standard for treating delayed scaphoid fracture union, and there are few reports of conservative treatment. In a meta-analysis of LIPUS for delayed union and non-union, with a treatment time of 20 min per day, the fusion rate was 78%, and the mean time required for fusion was 4 months [5] .…”

“…ESWT is reportedly effective for managing delayed union and non-union of various fractures, such as long bone and metatarsal fractures [3] , [4] . Surgical treatment is the gold standard for delayed union and non-union of scaphoid fractures, with only a few reports of successful outcomes after conservative treatment and low-intensity pulsed ultrasound (LIPUS) [5] and ESWT [4] , [6] . The choice of treatment for delayed union of scaphoid fractures remains controversial.…”

Transcriptome sequencing analysis reveals the effect of combinative treatment with low‑intensity pulsed ultrasound and magnesium ions on hFOB1.19 human osteoblast cells

“…In vivo , LIPUS has demonstrated great potential to assist freshfracture healing and shorten both cortical and endosteal union times. Notably, LIPUS exerts a potent effect on non-operatively managed fractures ( 25 – 28 ). Due to its efficacy, safety and conservative application, as supported by data from independent organizations, LIPUS is commonly used in clinical practice ( 19 ).…”