Low-Intensity Pulsed Ultrasound in the Treatment of Nonunions and Fresh Fractures: A Case Series
Carlo Luca Romanò,
Alexander Kirienko,
Clemente Sandrone,
Giuseppe Toro,
Antonio Toro,
Ettore Piero Valente,
Manlio Caporale,
Margareth Imbimbo,
Gabriele Falzarano,
Stefania Setti,
Enzo Meani
Affiliations
Carlo Luca Romanò
Studio Medico Associato Cecca-Romanò, 20121 Milan, Italy
Alexander Kirienko
External Fixation Unit, Humanitas Clinical and Research Center IRCCS, Via Manzoni 56, Rozzano, 20089 Milan, Italy
Clemente Sandrone
Osteoarticular Inflammatory Diseases Unit (MIOA), Department of Infectious Diseases and Septic Orthopaedics (MIOS), Santa Corona Hospital, 17027 Pietra Ligure (SV), Italy
Giuseppe Toro
Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80100 Naples, Italy
Antonio Toro
Unit of Orthopaedics and Traumatology, “Villa Malta” Hospital, ASL Salerno, 84087 Sarno, Italy
Ettore Piero Valente
Rehabilitation Department, INI Città Bianca, 03029 Veroli, Italy
Manlio Caporale
Orthopaedics and Traumatology Complex Operative Unit, DEA ASL Roma 5, 00019 Tivoli, Italy
Margareth Imbimbo
Orthopaedics and Traumatology Department, AULSS 2 Marca Trevigiana Presidi Ospedali (P.O.) of Conegliano and Vittorio Veneto, 31015 Conegliano, Italy
Gabriele Falzarano
Orthopaedics and Traumatology Department, A.O. “G.Rummo”, 82100 Benevento, Italy
Stefania Setti
IGEA Clinical Biophysics, 41012 Carpi, Italy
Enzo Meani
Department of Osteoarticular Infections, G. Pini Orthopaedic Institute, 20122 Milan, Italy
It is estimated that approximately 5% to 10% of fractures will evolve into nonunions. Nonunions have a significant impact on patient quality of life and on socioeconomic costs. Low-intensity pulsed ultrasound (LIPUS) is a non-invasive therapy widely used within the orthopedic community to accelerate the healing of fresh fractures, to minimize delayed healing, and to promote healing of nonunions. In this case series, 46 nonunions and 19 fresh fractures were treated with LIPUS for at least three months or until fracture healing. Bone healing was assessed both at a radiological and a functional level. Of the nonunions healed, 89% had a mean healing time of 89 ± 53 days. In the group of fresh fractures, the healing percentage was 95% with a mean healing time of 46 ± 28 days. LIPUS treatment is proven to be safe and well tolerated; there were no adverse events related to the use of the device, even in the presence of internal fixations and infections. LIPUS therapy should be considered a low-risk option both as an adjunct to surgery or as a standalone therapy in the management of nonunion and fresh fractures.
