title: Low-intensity pulsed ultrasound and pulsed electromagnetic field in the treatment of tibial fractures: a systematic review.
abstract: OBJECTIVE
  To compare the effects of low-intensity pulsed ultrasound (LIPUS) or pulsed electromagnetic fields (PEMF) on fracture healing through a systematic review of original, English-language clinical research reports.
  
  
  METHODS
  A search of MEDLINE, Physiotherapy Evidence Database (PEDro), and ProQuest to identify clinical trials of LIPUS or PEMF with fractures in humans, written in English, published from 1966 through 2004. Key words were ultrasound, fracture, tibial, electric current, and healing.
  
  
  METHODS
  After search limits were applied, 17 papers were assessed independently by 2 reviewers. Papers were excluded from consideration if they lacked (1) random allocation of treatments, (2) inclusion of skeletally mature patients of either sex with a current fracture, (3) blinding of both the patient and the assessors as to treatment group, (4) administration of either LIPUS or PEMF treatments to one of the treatment groups, or (5) assessment of time to fracture healing or proportion of fractures healed, as determined radiographically, clinically, or both.
  
  
  METHODS
  Eight trials met the inclusion criteria. Methodologic quality of all trials was assessed using the PEDro criteria. Outcome measures were tabulated.
  
  
  RESULTS
  Heterogeneity among studies precluded direct comparison of the efficacy of LIPUS to that of PEMF.
  
  
  CONCLUSIONS
  The studies we included in our review were of generally high methodologic quality. The evidence suggests that LIPUS may speed healing of acute tibial fractures. Comparison studies of these modalities are needed to guide treatment of fractures sustained by athletic individuals.
authors.affiliation: Pennsylvania State University, 146 Recreation Building, University Park, PA 16802-5702, USA. nikkiwerner@yahoo.com
authors.forename: Nicol A
authors.initials: NA
authors.lastname: Walker
authors.forename: Craig R
authors.initials: CR
authors.lastname: Denegar
authors.forename: Jody
authors.initials: J
authors.lastname: Preische
mesh_terms: D002986:Clinical Trials as Topic; D004574:Electromagnetic Fields; D017102:Fracture Healing; D006801:Humans; D013978:Tibial Fractures / Q000628:therapy*; D014464:Ultrasonic Therapy