Department of Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, Japan.
J Orthop Trauma. 2010 Mar;24 Suppl 1:S56-61. doi: 10.1097/BOT.0b013e3181d2efaf.
Low-intensity pulsed ultrasound (LIPUS) is a relatively new technique for the acceleration of fracture healing in fresh fractures and nonunions. It has a frequency of 1.5 MHz, a signal burst width of 200 micros, a signal repetition frequency of 1 kHz, and an intensity of 30 mW/cm2. In 1994 and 1997, two milestone double-blind randomized controlled trials revealed the benefits of LIPUS for the acceleration of fracture healing in the tibia and radius. They showed that LIPUS accelerated the fracture healing rate from 24% to 42% for fresh fractures. Some literature, however, has shown no positive effects. The beneficial effect of acceleration of fracture healing by LIPUS is considered to be larger in the group of patients or fractures with potentially negative factors for fracture healing. The incidence of delayed union and nonunion is 5% to 10% of all fractures. For delayed union and nonunion, the overall success rate of LIPUS therapy is approximately 67% (humerus), 90% (radius/radius-ulna), 82% (femur), and 87% (tibia/tibia-fibula). LIPUS likely has the ability to enhance maturation of the callus in distraction osteogenesis and reduce the healing index. The critical role of LIPUS for fracture healing is still unknown because of the heterogeneity of results in clinical trials for fresh fractures and the lack of controlled trials for delayed unions and nonunions.
低强度脉冲超声波（LIPUS）是一种相对较新的技术，可加速新鲜骨折和骨不连的愈合。它的频率为 1.5MHz，信号爆发宽度为 200 微秒，信号重复频率为 1kHz，强度为 30mW/cm2。1994 年和 1997 年，两项具有里程碑意义的双盲随机对照试验揭示了 LIPUS 加速胫骨和桡骨骨折愈合的益处。它们表明，LIPUS 将新鲜骨折的愈合速度从 24%提高到 42%。然而，一些文献表明没有积极的效果。LIPUS 加速骨折愈合的有益效果被认为在具有骨折愈合潜在负面因素的患者或骨折组中更大。延迟愈合和骨不连的发生率占所有骨折的 5%至 10%。对于延迟愈合和骨不连，LIPUS 治疗的总体成功率约为 67%（肱骨）、90%（桡骨/桡骨尺骨）、82%（股骨）和 87%（胫骨/胫骨腓骨）。LIPUS 可能具有增强牵张成骨中骨痂成熟和降低愈合指数的能力。由于新鲜骨折临床试验结果的异质性以及缺乏对延迟愈合和骨不连的对照试验，LIPUS 对骨折愈合的关键作用仍不清楚。
