Pulsed Ultrasounds Reduce Pain and Disability, Increasing Rib Fracture Healing, in a Randomized Controlled Trial

Abstract

Introduction Rib fractures are an important health issue worldwide, with significant, pain, morbidity, and disability for which only symptomatic treatment exists. Objectives Based on our previous experimental model, the objective of the current study was to assess for the first time whether pulsed ultrasound (PUS) application could have beneficial effects on humans. Methods Prospective, double-blinded, randomized, controlled trial of 51 patients. Four were excluded, and 47 were randomized into the control group (N = 23) or PUS group (N = 24). The control group received a PUS procedure without emission, and the PUS group received 1 Mhz, 0.5 W/cm2 for 1 min/cm2. Pain level, bone callus healing rate, physical and work activity, pain medication intake, and adverse events were blindly evaluated at baseline and one, three, and six months. Results There were no significant differences at baseline between groups. PUS treatment significantly decreased pain by month 1 (P = 0.004), month 3 (P = 0.005), and month 6 (P = 0.025), significantly accelerated callus healing by month 1 (P = 0.013) and month 3 (P < 0.001), accelerated return to physical activity by month 3 (P = 0.036) and work activity (P = 0.001) by month 1, and considerably reduced pain medication intake by month 1 (P = 0.057) and month 3 (P = 0.017). No related adverse events were found in the PUS group. Conclusions This study is the first evidence that PUS treatment is capable of improving rib fracture outcome, significantly accelerating bone callus healing, and decreasing pain, time off due to both physical activity and convalescence period, and pain medication intake. It is a safe, efficient, and low-cost therapy that may become a new treatment for patients with stable rib fractures.

Bone Growth Stimulators for Treatment of Adults with Bone Disease or Injury

“…The 5 included primary studies comprised 3 RCTs, [14][15][16] 1 retrospective cohort study, 17 and 1 prospective cohort study. 18 The studies were published between 2019 and 2020.…”

“…The SRs were conducted by authors from US 11 and Canada. 12,13 The primary clinical studies were conducted by authors from India, 14 Iran, 15 Spain, 16 US, 17 and Poland. 18 The economic evaluation study was conducted by authors from Canada.…”

“…Patients in the included primary studies were adults with mandibular fracture, 14,15 rib fracture, 16 undergoing thoracolumbar fusion, 17 and with distal radius fracture on cast immobilization surgery. 18 Mean age ranged from 27 years to 64 years.…”

“…One study 14 did not provide detailed characteristics of the included patients. The patient demographics of the other 4 studies [15][16][17][18] appeared to be balanced between groups.…”

“…The included primary studies compared LIPUS with placebo 16 or no LIPUS 14 as control, and PEMF with no PEMF 15,18 as control. One study 17 compared PEMF with combined magnetic field (CMF) stimulation and with no stimulation.…”