NEW YORK (Reuters Health) Mar 13 - The results of a meta-analysis of data from randomized trials suggest that low-intensity pulsed ultrasound therapy may reduce the healing time of fractures managed nonoperatively, according to a recent report by Canadian investigators.
Previous studies have yielded conflicting results regarding the benefits of ultrasound therapy for fractures. Potentially harmful effects linked to high-intensity continuous wave ultrasound has led to an absolute contraindication of such therapy in the presence of fractures. However, recent reports suggest that low-intensity pulsed ultrasound therapy may accelerate fracture healing.

Dr. Jason W. Busse, from Oncidium Health Group Inc. in Burlington, Ontario, and colleagues reviewed data from six randomized trials that investigated the fracture-healing effects of low-intensity pulsed ultrasound therapy. Three of the trials were of sufficient homogeneity to permit data pooling and a meta-analysis.

One of the trials, which was not included in the meta-analysis, was a repeat analysis of previous reported data. Findings from this trial suggested that ultrasound therapy did reduce fracture-healing time, the authors state in the February 19th issue of the Canadian Medical Association Journal.

The other two trials excluded from the meta-analysis yielded equivocal results. However, these trials appeared to report on a shared group of subjects and may have experienced a type II statistical error, the investigators note.

Analysis of the pooled data, which included 158 fractures, revealed that low-intensity pulsed ultrasound therapy significantly reduced fracture-healing time. On average, healing was achieved 64 days sooner in patients treated with this modality compared with control patients.

The current analysis suggests that ultrasound therapy may accelerate fracture healing, the researchers state. "This finding is of considerable importance in that treatment with a low-intensity pulsed ultrasound signal may reduce healing time and could yield substantial cost savings and decreases in disability associated with delayed union and nonunion of fractures."

CMAJ 2002;166:437-441.

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