Does ultrasound speed the healing of broken bones?

In brief

  • There is a lack of high quality evidence to support the use of low-intensity pulsed ultrasound therapy to speed the healing of broken bones, although overall results appear promising.
  • Future studies should measure recovery outcomes that are important to patients, such as return to function, rather than measuring bone healing using X-rays alone. 

Why was this review done?

Each year in North America, about six million people break a bone. For about five to 10 per cent of these people, the breaks don’t heal as well or as quickly as expected. To promote healing, doctors often use bone stimulators. Low-intensity pulsed ultrasound is one such stimulator, accounting for about half of the $500 million bone stimulator market in 2006. However, its widespread use remains an uncertain investment of limited health care dollars. High quality research showing that it improves patient recovery is missing. This systematic review looked at studies on the effectiveness of low-intensity pulsed ultrasound in speeding the healing of fractures and allowing patients to return to function.

How was the review done?

Researchers searched a number of clinical databases looking for eligible studies, in any language, on the effectiveness of low-intensity pulsed ultrasound therapy. Only randomized controlled studies were eligible. That is, the studies had to randomly divide patients with broken bones into one of two groups: those who received low-intensity pulsed ultrasound therapy and those who did not (the control group).

What did the researchers find?

In the end, 13 studies met the eligibility criteria and were included in the review. The overall results on the effectiveness of low-intensity pulsed ultrasound in healing fractures were promising. That said, the research evidence was moderate to very low in quality, and provided conflicting results.

For example, three low quality studies of fresh fractures did find a 37 per cent reduction in healing time, but one moderate quality study concluded that the treatment had no effect on the functional recovery of patients with freshly broken bones.

Most of the studies determined how well fractures were healing through the use of X-rays. Only five of the studies measured effectiveness based on functional outcomes, such as a return to work or time to weight-bearing.

What are some strengths and weaknesses of the review?

Strengths of this systematic review were that it was based on randomized controlled trials only, reflected a comprehensive search of the research literature, and included trials in any language.

Publication Information

Title: 

Low intensity pulsed ultrasonography for fractures: systematic review of randomized controlled trials

Author(s): 

Busse JW, Kaur J, Mollon B, Bhandari M, Tornetta P, Schunemann HJ, Guyatt G

Journal: 

British Medical Journal, 2009: vol. 338, p. 351