Authors' objectives: The purpose of this review is to investigate the effectiveness of low intensity ultrasound in treating patients with un-united fracture, to investigate the characteristics of fracture nonunion patients with the potential to respond to low intensity ultrasound, and to summarize the available high level evidence on the effectiveness of other bone growth stimulator devices and orthobiologics in treating fracture nonunion.

Authors' results and conclusions: Two hundred four published studies were identified from the literature search. Of these, thirty studies were retrieved in full and none of these were in the form of a higher level of evidence (level 1, 2 or 3) primary study. Manual searching on the systematic/experts reviews articles retrieved in this search did not identify any (new) higher level (level 1, 2 or 3) evidence as well. As such, although this update identified some low level (case series/reports. Level of evidence 4. Appendix 1) primary studies showing the effectiveness of LIPUS in treating fracture delayed- or non-union, our previous conclusion that, although ultrasound has been applied in treating fractures since at least the early 1950s, its role in fracture healing is still not well understood while to this date there is no high-level primary study providing evidence on the efficacy/effectiveness in treating fracture delayed- or non-union. This update did not identify any high-level primary study providing evidence on the efficacy/effectiveness in treating fracture delayed- or non-union. As such, our previous findings on the topic of LIPUS in treating delayed- or non-union fracture remain.

Authors' methods: In order to update our previous systematic review investigating the application of low intensity pulsed ultrasound (LIPUS) to treat delayed- or non-union fracture, we conducted a systematic literature search on January 31, 2024. Our previous review of this topic was originally done in 2006 and was then updated in 2015. Hence, in this round of update, the literature search was limited to those studies published from 2015 onward. The search was done on commercial medical literature databases. Same combination of keywords with our first update was also employed in this second update. Except for the publication date, no further limitation, such as on the language or country of publication, was implemented in the literature search.

Project Status: Completed

URL for project: https://www.worksafebc.com/en/about-us/research-services/evidence-based-medicine-and-systematic-reviews

Year Published: 2024

URL for published report: https://www.worksafebc.com/en/resources/health-care-providers/guides/low-intensity-ultrasound-treating-fracture-nonunion-other-bone-growth-stimulator-devices-orthobionomics-second-update-january-2024?lang=en&origin=s&returnurl=https%3A%2F%2Fwww.worksafebc.com%2Fen%2Fforms-resources%23sort%3DDate%26q%3DLow%2520Intensity%2520Ultrasound%2520for%2520Treating%2520Fracture%2520Nonunion%2520and%2520Short%2520Reviews%2520on%2520Other%2520Bone%2520Growth%2520Stimulator%2520Devices%2520and%2520Orthobionomics%253A%2520Second%2520Update%2520January%25202024%26f%3Alanguage-facet%3D%5BEnglish%5D%26tags%3DGuide%7C2d7eb4b30f6a4a319e0d40565c9abbab%2CHealth%2520Care%2520Provider%7C13468b0b3f074f6bade3f57ac3cdfb8e%2CSystematic%2520Review%7Cf78c29d570c14ec3b5a394385905df70&highlight=Low%20Intensity%20Ultrasound%20for%20Treating%20Fracture%20Nonunion%20and%20Short%20Reviews%20on%20Other%20Bone%20Growth%20Stimulator%20Devices%20and%20Orthobionomics:%20Second%20Update%20January%202024

English language abstract: An English language summary is available

Publication Type: Mini HTA

Country: Canada

Organisation Name: WorkSafeBC

Contact Address: 6591 Westminster Highway, Richmond, BC, V7C 1C6 Canada. Tel: 604-231-8417; Fax: 604-279-7698

Contact Name: ebpg@worksafebc.com

Contact Email: ebpg@worksafebc.com

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