Journal of Musculoskeletal Trauma

Treatment of Nonunion in the Long Bone with Low Intensity Pulsed Ultrasound (LIPUS) and LASER: In Ho Jeon, Chang Wug Oh, Sung Jung Kim, Hee Soo Kyung, Il Hyung Park, Byung Chul Park, Joo Chul Ihn, Jun Young Yeo; J Korean Soc Fract 2003;16(2):177-185. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.177

Abstract PDF: PURPOSE
Low-intensity, pulsed ultrasound (LIPUS) has demonstrated a stimulation and acceleration of the normal fracture-repair process in cellular bases as well in animal and human models. In this study, the adjunctive effect of LIPUS and LASER was investigated in established nonunion of the long bones.
MATERIALS AND METHODS
Study group consisted of eight patients to whom conventional bone graft and adjunctive LIPUS and LASER was applied. On the other hand, eight patients in the control group underwent bone graft only. Eleven men and five women were included in this study and the average age of the patients was 41.7 years (range, 19~62 years). Six of the tibias and ten of the femurs met the criteria for established nonunion. The average fracture age, the post-fracture period before the start of LIPUS/LASER treatment, was 502 days.
RESULTS
Seven of the ten nonunions who were treated by LIPUS and LASER healed completely in an average treatment time of 141 days (range, 101~202 days) and otherwise, in control group, five of the eight nonunions healed completely, in 240 days (range, 183~283 days).
CONCLUSION
This clinical study showed a positive effect of LIPUS and LASER on the rate of osseous repair, especially accelerated time to initial callus cortical bridging compared to that of conventional treatment.

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The Usefulness of Low-Intensity Ultrasound for Nonunion and Delayed Union: Yeo Heon Yun, Jong Oh Kim, Young Do Ko, Jae Doo Yoo, Jun Mo Jung, Jong Gun Oh, Han Chen Bang, Chang Ho Choi, Myeung cheol Shin; J Korean Soc Fract 2003;16(1):104-111. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.104

Abstract PDF: PURPOSE
To evaluation of usefulness of low-intensity ultrasound for nonunion and delayed union.
MATERIALS AND METHODS
For 5 months, we treated 7 delayed union and 8 nonunion using low-intensity ultrasound. After 5 months, in checked X-ray AP and Lateral view, when cortical bridge formation was done, we through union.
RESULTS
In 7 delayed union, 5 cases-2 femur, tibia, humerus, radius were healed. In 8 nonunion, 3 femur nonunion were healed. Union rate was 71% in delayed union 37.5% in nonunion.
CONCLUSION
we thought that the low-intensity ultrasound has capacity of induction of union and was considered as the method of treatment for delayed union.

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The Effect of Low Intensity Ultrasound on Distraction Osteogenesis in the Rabbit Femur: Hyung Bin Park, Hae Ryoung Song, Kyung Hoi Koo, Soon Taek Jeong, Bun Jung Kang, Se Hyun Cho; J Korean Soc Fract 2002;15(2):159-165. Published online April 30, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.2.159

Abstract PDF: PURPOSE
The effects of ultrasound on mechanical properties of the callus in distraction osteogenesis was assessed in this study. MATERIAL AND METHOD: Forty mature New Zealand white rabbits were divided into two groups (ultrasound group and control group). A midshaft femoral osteotomy was made and fixed with a small external fixator. After a latent period of a week, lengthening was performed at the rate of 1mm a day for 2 weeks. Low intensity ultrasound (EXOGEN inc, Piscataway, NJ U.S.A) was applied to the operated limb for 20 minutes a day in the ultrasound group, while the control group waited for natural maturation of the callus. The bone mineral density and mechanical properties such as ultimate load, ultimate stress, deflection at ultimate load, ultimate stiffness and energy absorption at ultimate load were measured and analyzed.
RESULT
The bone mineral density, the area of the callus, ultimate load, ultimate stress and energy absorption at ultimate load were not significantly different between the two groups (p>0.05). The ultimate stiffness in the ultrasound group was significantly higher than those of the control group (p<0.01). The deflection at ultimate load in the ultrasound group was significantly lower than those of the control group (p<0.01).
CONCLUSION
The low density ultrasound has a positive effect on the mechanical properties of the distracted callus in the rabbit femoral model in terms of the ultimate stiffness and the deflection at ultimate load.

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Effect of the Ultrasound and LASER in the fracture healing in rabbits: Jun Young Yang, Kwang Jin Rhee, June Kyu Lee, Deuk Soo Hwang, Hyun Dae Shin, Jun ho Lee; J Korean Soc Fract 2001;14(3):305-312. Published online July 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.3.305

Abstract PDF: PURPOSE
To study the effectiveness of the ultrasound and LASER on the fracturehealing in rabbits.
MATERIALS AND METHODS
This study was performed on rabbits using the Hi-Tech 2000 (Ultrasound+LASER) which was made in our institute. After anesthesia of the rabbit, the shaft of tibia was fractured with Gigli saw under aseptic condition, and then intramedullary nailing using K-wire was performed. We evaluated left tibia as control and right tibia as experimental. we applicated ultrasound and LASER from 7 days after operation and sacrificed at 3 weeks and 5 weeks after operation. Gross findings, simple radiologic findings, and histologic findings were evaluated by modified Zorlu scoring system. With use of T-test of SAS system ( level of significance, P < 0.05 ), difference between left and right tibia were evaluated to be determined the effect of ultrasound and LASER on the fracture-healing.
RESULTS
At postoperative 3 weeks, differences were noted in 4 cases but we could detect no significant difference between left and right side. At postoperative 5 weeks, differences were noted 6 cases and significant difference was noted.
CONCLUSIONS
Seeing this results, ultrasound and LASER treatment was effective in fracture healing. However we think that additional studies for accurate quantitative and qualitative analysis, biomechanical test in callus, microangiographic study and clinical research to determine the effectiveness of ultrasound and LASER in clinical field are needed.

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Stimulation of fracture Healing by Low-Intensity Pulsing Ultrasound: Kyu Hyun Yang, Chong Hyuk Choi, Jae Ho Cho; J Korean Soc Fract 1998;11(2):247-253. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.247

Abstract PDF

We performed a preliminary study to evaluate the effect of ultrasound in canine osteotomy model. Both ulna shafts were osteotomized and one side was irradiated with low-energy pulsing ultrasound, 50mW/cm2, 1 MHz, 200 microsecond bursting sine wave for 15 minutes, 6 days a week. Effect on the fracture healing was evaluated by radiologic scoring system, amount of uptake of radioactive isotope, and time to union. Results were as follows : At postoperative 2 months, means of the radiologic healing score were 4.5 in the irradiated side and 2.5 on the control side (p=0.019). Mean isotope uptake in the irradiated side was 44.4 count and 33.8 count in the control side (p=0.028). Two nonunion developed on the control side. Mean time to union of eight dogs was 2.6 months in the irradiated side and 3.1 months on the control side. Based on the cumulative union rate curve, fracture healing was stimulated and union was obtained one month faster in the irradiated side than the control side.

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Alterations in Serum Levels of Receptor Activator of Nuclear Factor-κB Ligand and Osteoprotegerin in Patients with Head Injury and Fracture
Shin Young Park, Kuen Tak Suh, Chang Hoon Ryu, Seung Hun Woo, Jung Sub Lee, Seong-Gang Kim
Journal of the Korean Fracture Society.2008; 21(2): 145. CrossRef

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