Accelerating Bone Healing: The Role of Ultrasound Therapy in Orthopedics

Q: Accelerating Bone Healing: The Role of Ultrasound Therapy in Orthopedics

Hello, in response to your question： 1. Bone fractures require various conditions for healing. The first is whether the fracture was managed correctly. Based on your description, the use of intramedullary nails and plaster cast fixation should be sufficient. T

Ultrasound Bone Healing Acceleration System

Hello Doctor, I had an open fracture of the right foot's metatarsal on January 18th, and I underwent surgery with intramedullary nailing about 10 centimeters below the knee.
I had my cast removed on February 14th and returned for a follow-up on April 4th.
The X-ray showed that my bone has not healed at all, and the doctor advised me to wait another month for a check-up.
I am quite anxious since it has been almost three months.
The doctor mentioned that if there is still no healing, a bone graft might be necessary.
I also came across a system called ultrasound bone healing acceleration, but I'm unsure of its effectiveness.
I found the price online to be 54,000.
I would like to ask if the doctor would provide a certificate stating that the patient needs this treatment, as the insurance company requires a doctor's proof for reimbursement.
Also, does this mean my bone healing is significantly delayed? (I have not seen any healing at all.) Thank you!

Xiao Jie, 20~29 year old female. Ask Date: 2007/04/10

Dr. Li Wenlin reply Orthopedics

Hello, in response to your question:
1.
Bone fractures require various conditions for healing.
The first is whether the fracture was managed correctly.
Based on your description, the use of intramedullary nails and plaster cast fixation should be sufficient.
The second factor is personal habits, such as maintaining a regular lifestyle and avoiding smoking or drinking alcohol.
You can control the second factor, so a regular lifestyle and adequate nutrition are very important.
2.
Additionally, it has only been three months.
Generally, if there is no significant bone growth after nine months of follow-up, then bone grafting may be necessary.
As for the effectiveness of the ultrasound bone healing acceleration system, literature shows promising results, with about 50% to 70% of clinical users experiencing significant effects.
If financially feasible, I recommend considering its use.
3.
This ultrasound bone healing acceleration system is not a mandatory clinical requirement, and it may be challenging to obtain a physician's prescription for it.
However, you can ask your attending physician about it!
4.
The likelihood of non-union in young individuals with tibial fractures is low, so please be patient with outpatient follow-ups and try not to worry too much.

Reply Date: 2007/04/10

More Info

Accelerating bone healing is a critical aspect of orthopedic treatment, especially in cases of fractures. Ultrasound therapy has emerged as a promising adjunctive treatment modality in this regard. Your situation, involving an open fracture of the right foot with internal fixation, raises important considerations regarding bone healing and the potential role of ultrasound therapy.

Ultrasound therapy, particularly low-intensity pulsed ultrasound (LIPUS), has been studied for its effects on bone healing. Research indicates that LIPUS can stimulate cellular activity in the bone, enhance the production of growth factors, and promote angiogenesis (the formation of new blood vessels), all of which are crucial for bone repair. The mechanism involves the stimulation of osteoblasts (bone-forming cells) and the enhancement of the healing process at the fracture site. This therapy is non-invasive and can be administered in a clinical setting or at home with portable devices.

In your case, the fact that your X-rays show no signs of bone healing after three months is concerning. Typically, bone healing can take anywhere from six to twelve weeks, depending on various factors, including the type of fracture, the patient's age, nutritional status, and overall health. If there is no evidence of healing, it may indicate a non-union or delayed union, which can necessitate further intervention, such as bone grafting.

Regarding the ultrasound bone healing system you mentioned, while it has shown promise in clinical studies, its effectiveness can vary from patient to patient. The cost you referenced (approximately $54,000) is significant, and it’s essential to weigh the potential benefits against the financial implications. If your physician believes that ultrasound therapy could be beneficial for your healing process, they may be willing to provide a medical justification for insurance purposes. This would typically involve documenting your current condition, the lack of healing, and the potential benefits of ultrasound therapy in your specific case.

It’s also important to have an open discussion with your orthopedic surgeon about your concerns regarding slow healing. They can provide insights into whether your situation qualifies as delayed union or non-union and discuss the best course of action moving forward. This may include additional imaging studies, a reassessment of your treatment plan, or even surgical options if necessary.

In summary, ultrasound therapy can play a role in accelerating bone healing, but its effectiveness can vary. Given your current situation, it is crucial to maintain close communication with your orthopedic surgeon to explore all available options, including ultrasound therapy, and to ensure that you receive the most appropriate care for your condition. If you are considering this treatment, ask your doctor for their professional opinion and whether they would support a request for insurance coverage based on your medical needs.

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