III–1 Application of Low-Intensity Pulsed Ultrasound (LIPUS) for Carpal Fractures

Abstract

Objective: There are few reports on the clinical application of low intensity pulsed ultrasound (LIPUS) for fractures of the hand. The aim of this study was to investigate the clinical outcomes of carpal fractures treated with LIPUS. Methods: We conducted a retrospective study to investigate the clinical characteristics of patients with the carpal fractures treated with LIPUS and their clinical outcomes. Results: Fifteen patients with carpal fractures underwent LIPUS in our institute. The average age was 31.6 years old. Ten scaphoid, 4 hamate (3 hook and 1 body), and 1 triangular fractures were included. One scaphoid fracture and 3 hamate hook fractures were treated conservatively, and the mean duration from injury to the application of LIPUS was 2.5 months. The other 11 patients received surgical treatment at an average of 26.5 months after injury, and the mean duration from surgery to the application of LIPUS was 2.2 months. Bone union was achieved in all 4 cases treated conservatively and in 9 of 11 cases treated surgically. The mean periods from LIPUS application to bone union was 4.3 months in the conservative treatment group and 4.2 months in the surgical treatment group. Discussion: It is expected that LIPUS is effective for carpal fractures because they are close to the skin surface. Although bone union was not achieved in 2 cases which received surgical treatment, the failure to achieve bone union is thought to be caused by insufficient screw fixation in one case and bone defect at the fracture site in another case. Similar to other fractures, LIPUS could be useful as adjuvant therapy for carpal fractures as long as adequate mechanical stability at the fracture site is achieved.