title: Low-intensity pulsed ultrasound shortens the treatment time in tibial distraction osteogenesis.
abstract: OBJECTIVE
  Low-intensity pulsed ultrasound (LIPUS) has been used successfully to accelerate healing of fresh fractures and non-unions. It also improved callus maturation with distraction osteogenesis in animal trials. However, only few clinical studies are available to support its widespread use for the latter indication in humans.
  
  
  METHODS
  Twenty-one patients undergoing callus distraction for posttraumatic tibial defects were randomized into two groups: the trial group (12 men; mean age 32 years) which received 20 minutes LIPUS daily during treatment and the control group (six men and three women; mean age 29 years) without LIPUS treatment. The Ilizarov ring fixator was used in all cases. Results were examined clinically and radiologically, analysing callus maturation with a computer-assisted measurement.
  
  
  RESULTS
  Patients in the LIPUS group needed a mean of 33 days to consolidate every 1 cm of new bone in comparison to 45 days in the control group. The healing index was therefore shortened by 12 days/cm in the LIPUS group. This means that callus maturation was 27 % faster in the LIPUS group. The fixator time was shortened by 95 days in the LIPUS group. The overall daily increase in radiographic callus density was 33 % more in the LIPUS group than in the control group.
  
  
  CONCLUSIONS
  LIPUS treatment is an effective non-invasive adjuvant method to enhance callus maturation in distraction osteogenesis. With the help of this treatment, the healing time and the duration of external fixation can be reliably shortened.
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, Cairo University, Kasr El-Aini Street, 11562, Cairo, Egypt, khaled_hamedsalem@hotmail.com.
authors.forename: Khaled Hamed
authors.initials: KH
authors.lastname: Salem
authors.forename: Andreas
authors.initials: A
authors.lastname: Schmelz
mesh_terms: D000328:Adult; D015519:Bone Density; D002146:Bony Callus / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D017102:Fracture Healing / Q000528:radiation effects*; D006801:Humans; D008297:Male; D019857:Osteogenesis, Distraction / Q000379:methods*; D011859:Radiography; D013977:Tibia / Q000000981:diagnostic imaging* / Q000601:surgery; D013997:Time Factors; D014464:Ultrasonic Therapy; D014463:Ultrasonography