Low-intensity pulsed ultrasound enhances callus consolidation in distraction osteogenesis of the tibia by the technique of lengthening over the nail procedure
Abstract Background Low-intensity pulsed ultrasound (LIPUS) has been widely accepted in promoting the fracture healing process. However, there have been limited clinical trials focused on the efficacy of LIPUS during distraction osteogenesis (DO) by the technique of lengthening over the nail procedu...
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| Format: | Article |
| Language: | English |
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BMC
2019-03-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12891-019-2490-7 |
| _version_ | 1828355442047188992 |
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| author | Mi Hyun Song Tae-Jin Kim Sung Hyun Kang Hae-Ryong Song |
| author_facet | Mi Hyun Song Tae-Jin Kim Sung Hyun Kang Hae-Ryong Song |
| author_sort | Mi Hyun Song |
| collection | DOAJ |
| description | Abstract Background Low-intensity pulsed ultrasound (LIPUS) has been widely accepted in promoting the fracture healing process. However, there have been limited clinical trials focused on the efficacy of LIPUS during distraction osteogenesis (DO) by the technique of lengthening over the nail procedure. The purpose of the current study was to evaluate the efficacy of LIPUS during DO. Methods We retrospectively evaluated 30 patients (60 segments) who underwent simultaneous bilateral tibial lengthening over the nail. The patients were grouped into the LIPUS group and the control group based on LIPUS stimulation. The two patient groups were compared for demographic data (sex, age at operation, preoperative height, BMI, and smoking history), qualitative assessments of the callus (callus shape and type), external fixation index, and four cortical healing indexes. Results Fifteen patients (30 segments) were classified as the LIPUS group, and another 15 patients (30 segments) were classified as the control group. No significant differences were found in the assessed demographic data between the groups. LIPUS stimulated a more cylindrical, more homogenous, and denser type of callus formation at the end of the distraction phase. The two groups exhibited equivalent outcomes in terms of external fixation index (p = 0.579). However, significant differences were found in healing indexes of the anterior and medial cortices (p < 0.001 and p = 0.002, respectively). The healing indexes of those cortices in the LIPUS group (mean of 36.6 days/cm and 32.5 days/cm, respectively) reflected their significantly faster healing compared to the control group (mean HI of 57.5 days/cm and 44.2 days/cm, respectively). There were no LIPUS-related complications. Conclusions LIPUS is a noninvasive and effective adjuvant therapy to enhance callus maturation during DO. It enhances callus consolidation and may have a positive effect on the appropriate callus shape and type. |
| first_indexed | 2024-04-14T02:42:26Z |
| format | Article |
| id | doaj.art-7294014acaee48cd8cd3feb3ee60b421 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-04-14T02:42:26Z |
| publishDate | 2019-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-7294014acaee48cd8cd3feb3ee60b4212022-12-22T02:16:49ZengBMCBMC Musculoskeletal Disorders1471-24742019-03-012011810.1186/s12891-019-2490-7Low-intensity pulsed ultrasound enhances callus consolidation in distraction osteogenesis of the tibia by the technique of lengthening over the nail procedureMi Hyun Song0Tae-Jin Kim1Sung Hyun Kang2Hae-Ryong Song3Department of Orthopaedic Surgery and Institute for Rare Diseases, Korea University Medical Center, Guro HospitalDepartment of Orthopaedic Surgery and Institute for Rare Diseases, Korea University Medical Center, Guro HospitalDepartment of Orthopaedic Surgery and Institute for Rare Diseases, Korea University Medical Center, Guro HospitalDepartment of Orthopaedic Surgery and Institute for Rare Diseases, Korea University Medical Center, Guro HospitalAbstract Background Low-intensity pulsed ultrasound (LIPUS) has been widely accepted in promoting the fracture healing process. However, there have been limited clinical trials focused on the efficacy of LIPUS during distraction osteogenesis (DO) by the technique of lengthening over the nail procedure. The purpose of the current study was to evaluate the efficacy of LIPUS during DO. Methods We retrospectively evaluated 30 patients (60 segments) who underwent simultaneous bilateral tibial lengthening over the nail. The patients were grouped into the LIPUS group and the control group based on LIPUS stimulation. The two patient groups were compared for demographic data (sex, age at operation, preoperative height, BMI, and smoking history), qualitative assessments of the callus (callus shape and type), external fixation index, and four cortical healing indexes. Results Fifteen patients (30 segments) were classified as the LIPUS group, and another 15 patients (30 segments) were classified as the control group. No significant differences were found in the assessed demographic data between the groups. LIPUS stimulated a more cylindrical, more homogenous, and denser type of callus formation at the end of the distraction phase. The two groups exhibited equivalent outcomes in terms of external fixation index (p = 0.579). However, significant differences were found in healing indexes of the anterior and medial cortices (p < 0.001 and p = 0.002, respectively). The healing indexes of those cortices in the LIPUS group (mean of 36.6 days/cm and 32.5 days/cm, respectively) reflected their significantly faster healing compared to the control group (mean HI of 57.5 days/cm and 44.2 days/cm, respectively). There were no LIPUS-related complications. Conclusions LIPUS is a noninvasive and effective adjuvant therapy to enhance callus maturation during DO. It enhances callus consolidation and may have a positive effect on the appropriate callus shape and type.http://link.springer.com/article/10.1186/s12891-019-2490-7Distraction osteogenesisLow-intensity pulsed ultrasoundHealing indexCallus maturation |
| spellingShingle | Mi Hyun Song Tae-Jin Kim Sung Hyun Kang Hae-Ryong Song Low-intensity pulsed ultrasound enhances callus consolidation in distraction osteogenesis of the tibia by the technique of lengthening over the nail procedure BMC Musculoskeletal Disorders Distraction osteogenesis Low-intensity pulsed ultrasound Healing index Callus maturation |
| title | Low-intensity pulsed ultrasound enhances callus consolidation in distraction osteogenesis of the tibia by the technique of lengthening over the nail procedure |
| title_full | Low-intensity pulsed ultrasound enhances callus consolidation in distraction osteogenesis of the tibia by the technique of lengthening over the nail procedure |
| title_fullStr | Low-intensity pulsed ultrasound enhances callus consolidation in distraction osteogenesis of the tibia by the technique of lengthening over the nail procedure |
| title_full_unstemmed | Low-intensity pulsed ultrasound enhances callus consolidation in distraction osteogenesis of the tibia by the technique of lengthening over the nail procedure |
| title_short | Low-intensity pulsed ultrasound enhances callus consolidation in distraction osteogenesis of the tibia by the technique of lengthening over the nail procedure |
| title_sort | low intensity pulsed ultrasound enhances callus consolidation in distraction osteogenesis of the tibia by the technique of lengthening over the nail procedure |
| topic | Distraction osteogenesis Low-intensity pulsed ultrasound Healing index Callus maturation |
| url | http://link.springer.com/article/10.1186/s12891-019-2490-7 |
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