Farkash Uri, Bain Orit, Gam Arnon, Nyska Meir, Sagiv Paul
Central Orthopedic Clinic, IDF, Zerifin, Israel.
Department of Orthopedic Surgery, Meir Medical Center, 59 Tchernihovsky St, Kfar-Saba, 44281, Israel.
J Orthop Surg Res. 2015 May 20;10:72. doi: 10.1186/s13018-015-0221-9.
The standard treatment to enhance fracture healing of scaphoid nonunions is surgery. Low-intensity pulsed ultrasound (LIPUS) is gaining in popularity as an alternative treatment to improve fracture healing; however, little is known about success rates of this treatment in scaphoid-delayed unions. The purpose of our study is to define the success rate of LIPUS treatment for delayed union of scaphoid fractures and further analyze whether initial management or fracture type influences success rate.
During the period of 2011-2013, in the central orthopedic clinic of our institution, patients diagnosed with delayed union of the scaphoid were offered with LIPUS treatment as an alternative to conventional surgical treatment. These patients were then divided into subgroups according to the time elapsed from initial injury until diagnosis of the fracture.
Overall, 22 of 29 (76%) fractures healed, 12 of 13 (92%) of the early diagnosed group, and 10 of 16 (63%) of the late diagnosed group. Difference in healing rate between proximal pole, waist, and distal pole fractures was not statistically significant.
LIPUS can help heal delayed union scaphoid fractures, especially in fractures diagnosed and treated soon after injury and may serve as an alternative to surgical treatment.
增强舟骨不愈合骨折愈合的标准治疗方法是手术。低强度脉冲超声（LIPUS）作为一种促进骨折愈合的替代治疗方法正逐渐受到欢迎；然而，对于这种治疗方法在舟骨延迟愈合中的成功率知之甚少。我们研究的目的是确定LIPUS治疗舟骨骨折延迟愈合的成功率，并进一步分析初始治疗或骨折类型是否会影响成功率。
在2011年至2013年期间，在我们机构的中心骨科诊所，为诊断为舟骨延迟愈合的患者提供LIPUS治疗，作为传统手术治疗的替代方法。然后根据从最初受伤到诊断骨折所经过的时间将这些患者分为亚组。
总体而言，29例骨折中有22例（76%）愈合，早期诊断组13例中有12例（92%），晚期诊断组16例中有10例（63%）。近端极、腰部和远端极骨折的愈合率差异无统计学意义。
LIPUS可帮助愈合舟骨骨折延迟愈合，尤其是在受伤后不久诊断和治疗的骨折，并且可作为手术治疗的替代方法。
