Low-intensity pulsed ultrasound (LIPUS) in fresh clavicle fractures: A multi-centre double blind randomised controlled trial

Background: Several randomised trials have been published on the effect of low-intensity pulsed ultrasound (LIPUS) on fracture heating in both distal radius and tibia fractures. Most studies showed a positive effect on time to clinical and radiological heating. We hypothesised that LIPUS has a beneficial effect on the heating of fresh clavicle fractures as well and studied its effect in non-operatively treated shaft fractures. Methods: We conducted a randomised double blind, placebo-controlled multi-centre trial in 101 adult patients with a non-operatively treated fresh clavicle shaft fracture. Of these patients, 49 used a placebo transducer and 52 patients had an active transducer with ultrasound stimulation (Exogen 2000 (R)). Data were analysed on intention to treat basis. Baseline parameters of both groups were not significantly different. Results: There were no differences in time to subjective clinical fracture heating, resumption of daily activities, sports or professional work, Visual Analogue pain Scores (VAS) and use of pain medication. Conclusion: Our findings did not confirm that LIPUS accelerates clinical heating time of fresh clavicle shaft fractures. Level of evidence: Level 1 evidence that low-intensity pulsed ultrasound does not accelerate clinical fracture heating in non-operatively treated fresh midshaft clavicle fractures. (C) 2008 Elsevier Ltd. All rights reserved.