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Low intensity pulsed ultrasound (Lipus) as a non-surgical cost effective method of managing atrophic non-union

Samena Chaudhry, Rohan Rajan, Sarah Rubin, Yvonne Mary Papamerkouriou

Introduction: Non-unions are difficult to treat and have a high financial impact. Low intensity pulsed ultrasound (LIPUS) is one method of enhancing healing in non unions without the risks and complications of a surgical procedure. Our aim was to review the outcomes of LIPUS use in a group of patients with atrophic non union. Methods: Patients diagnosed with atrophic non union during the recruitment period were prospectively followed up for up to 2 years with clinical and radiological assessments. Union was diagnosed when the patient was pain free on clinical examination and cortices demonstrated bony bridging with no pain. Results: Of the 15 patients (10 female, 5 male) reviewed, mean time of non union prior to treatment was 12.7 months. 1 patient was lost to follow up. Union in 93% of patients occurred within 6 months. Compliance with use of the device was 80%. 1 patient did not achieve healing of a mid shaft humeral fracture at 2 years but remained pain free. Discussion: Our results highlight the important role LIPUS may have in patients with atrophic non union, especially for patients deemed unsuitable to undergo complex surgical procedures.