Abstract
IntroductionSevere injuries of the hand or single fingers require immediate treatment but surgical fixation methods are limited depending on soft tissue damage. Thus, it is very common that severe soft tissue damage along with poor osteosynthetic bone fixation results in a delayed healing process or nonunion. Low-intensity pulsed ultrasound (LIPUS) has been proven to stimulate bone formation in in vitro studies and also to significantly accelerate nonunion healing in animal studies and clinical trials but to date there are no data with respect to nonunion in phalanx fracture.Case presentationWe report a case in which we successfully used LIPUS in a 19-year-old Caucasian man with a nonunion of his ring finger after injury and first treatment with K-wire osteosynthesis.ConclusionWe recommend that LIPUS be considered as an option to treat nonunions in fractures of the hand, especially because it is a soft tissue conserving method with a good functional result.
Highlights
Severe injuries of the hand or single fingers require immediate treatment but surgical fixation methods are limited depending on soft tissue damage
We recommend that Low-intensity pulsed ultrasound (LIPUS) be considered as an option to treat nonunions in fractures of the hand, especially because it is a soft tissue conserving method with a good functional result
Phalanx fracture fixation is needed in most cases and should be limited to a short period of time in order to achieve a range of motion (ROM) without restriction
Summary
Low intensity pulsed ultrasound (LIPUS) has been the focus of several studies examining how to help stimulate bone formation in fractures and nonunions [1,2,3]. Up to now in cases of nonunions, trauma surgeons have had to perform additional surgery with a more stable osteosynthesis and bone grafting This can cause additional complications to the already pre-damaged soft tissue with further loss of function [4,5]. In this case we successfully used LIPUS, a non invasive treatment, to investigate its applicability in treating nonunion of fingers. Weeks after LIPUS treatment the patient reported to be without pain when moving his ring finger and clinical examination revealed a slight persistent ulna deviation of five degrees.
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