Trauma and Orthopaedics, Specialty Registrar, The Birmingham Orthopaedic Training Program, The Royal Orthopaedic Hospital, Birmingham B31 2AP, UK.
College of Medical and Dental Sciences, Birmingham Medical School, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
Injury. 2022 Oct;53(10):3214-3219. doi: 10.1016/j.injury.2022.06.030. Epub 2022 Jun 24.
Low-intensity pulsed ultrasound (LIPUS) is a non-invasive treatment modality for delayed union or non-union of acute fractures. We aimed to assess the current use of LIPUS at a national level in the United Kingdom, why and how clinicians use it, what treatment protocols are followed, and what the current perceptions are on this technology.
Using a detailed online survey compromised of 20 questions delivered to known LIPUS users, we were able to collect qualitative data on indication of use, type of machine used, personal views on the technology, frequency of usage, and treatment protocols. Each question was peer-reviewed to exclude bias.
A total of 70 respondents completed the survey. LIPUS was used by most clinicians for cases of non-union (N = 55, 78.5%) and delayed union (N = 51, 72.8%). The majority of respondents personally used a LIPUS device between 1 and 5 times in 12 months (N = 38, 54.3%). Most considered LIPUS a failure after three to six months of treatment without clinical improvement (N = 39, 55.7%). A total of 32 respondents (45.7%) mentioned the need for funding approval before accessing LIPUS technology. Poor revision surgery candidates (N = 48, 68.6%) and atrophic non-union (N = 46, 65.7%) were the most frequently cited reasons for using LIPUS technology as treatment. Most participants (N = 48, 68.6%) considered LIPUS to be cost-effective. Despite most clinicians being comfortable with the use of LIPUS, some respondents did not understand the basic science underpinning the technology nor could explain the need for LIPUS to patients comfortably.
LIPUS technology may have a significant role to play in the treatment of orthopaedic fracture related pathology. Regular users perceived the technology to be cost-effective and efficacious. Further research should standardize treatment protocols and aim to establish a national LIPUS registry.
低强度脉冲超声波（LIPUS）是治疗急性骨折延迟愈合或不愈合的一种非侵入性治疗方法。我们旨在评估英国全国范围内 LIPUS 的使用现状，包括临床医生使用 LIPUS 的原因、方式、遵循的治疗方案以及对该技术的当前看法。
我们使用一份详细的在线调查，其中包含 20 个问题，分发给已知的 LIPUS 用户，以收集关于使用指征、使用的机器类型、个人对该技术的看法、使用频率和治疗方案的定性数据。每个问题都经过同行评审，以排除偏见。
共有 70 名受访者完成了调查。大多数临床医生将 LIPUS 用于治疗不愈合（N=55，78.5%）和延迟愈合（N=51，72.8%）的病例。大多数受访者在 12 个月内个人使用 LIPUS 设备的次数为 1 到 5 次（N=38，54.3%）。大多数人认为，如果在治疗三到六个月后没有临床改善，LIPUS 治疗就会失败（N=39，55.7%）。共有 32 名受访者（45.7%）提到在使用 LIPUS 技术前需要获得资金批准。需要进行翻修手术的患者（N=48，68.6%）和萎缩性不愈合（N=46，65.7%）是最常被引用的使用 LIPUS 技术治疗的原因。大多数参与者（N=48，68.6%）认为 LIPUS 具有成本效益。尽管大多数临床医生对 LIPUS 的使用感到满意，但有些受访者不了解该技术的基础科学，也无法向患者解释使用 LIPUS 的必要性。
LIPUS 技术可能在治疗骨科骨折相关疾病方面发挥重要作用。经常使用者认为该技术具有成本效益和疗效。进一步的研究应该标准化治疗方案，并旨在建立一个全国性的 LIPUS 登记处。
