No effect of low-intensity ultrasound on healing time of intramedullary fixed tibial fractures

Objective: To determine whether stimulation with low-intensity ultrasound w ill reduce the radiologic healing time of fresh tibial Shaft fractures fixe d with a reamed and statically locked intramedullary rod. Design: Prospective, randomized, double blinded, and placebo controlled. Patients and Methods: Thirty-two adult patients were included, fifteen in t he active ultrasound group and seventeen in the placebo group. They all use d an ultrasound device twenty minutes daily for seventy-five-days without k nowing whether it was active or inactive. Standardized radiographs were tak en every third week until healing and at six and twelve months. All radiogr aphs were assessed blinded and independently by a radiologist and an orthop aedic surgeon. The codes were not broken until all fractures bad healed and all radiographs had been evaluated. Results: The time until the first visible callus averaged 40 +/- 3 days for the active group and 37 +/- 3 days for the placebo (p = 0.44). The healing time, defined as radiologic bridging of three cortices, was on average 155 +/- 22 days (median 113 days) for the active treatment group and 125 +/- 1 1 days (median 112 days) for the placebo group (p = 0.76) as assessed by th e radiologist and 128 +/- 13 days fdr the active group and 114 +/- 9 days f or the placebo group (p = 0.40) as evaluated by the orthopaedic surgeon. Conclusion: We conclude that low-intensity ultrasound treatment did not sho rten healing time in fresh tibial fractures treated with a reamed and stati cally locked intramedullary nail. Our results are not in accordance with pr evious findings reporting reduced healing time in nonoperatively treated ti bial shaft fractures when subjected to ultrasound.