This 1994 Level I RCT tested whether low-intensity pulsed ultrasound (LIPUS) accelerates healing of closed or grade-I open tibial shaft fractures treated with casting. 17-site, double-blind, placebo-controlled trial with 67 protocol-compliant fractures (33 active, 34 placebo). The study established whether 20 minutes of daily LIPUS at 30 mW/cm² could meaningfully shorten time to union.
A 38% reduction in healing time is not a statistical abstraction — for a patient in a cast, it means getting back to work and weight-bearing nearly two months sooner.
When you have a young, active patient with a closed or grade-I open tibial shaft fracture managed nonoperatively, LIPUS is a Level I-supported adjunct worth offering: 20 minutes per day at home, started within one week of injury, continued up to 20 weeks.
The Cox regression data are reassuring for clinical decision-making. The benefit does not depend on age, sex, fracture pattern, or when weight-bearing starts. So you do not need to stratify patients before recommending it.
Patient selection matters. This trial enrolled only transverse, short oblique, and short spiral diaphyseal fractures with a gap under 5 mm and displacement under 50%. Do not extrapolate to comminuted, metaphyseal, or higher-grade open fractures. Those were explicitly excluded.
This 1994 Level I RCT tested whether low-intensity pulsed ultrasound (LIPUS) accelerates healing of closed or grade-I open tibial shaft fractures treated with casting. 17-site, double-blind, placebo-controlled trial with 67 protocol-compliant fractures (33 active, 34 placebo). The study established whether 20 minutes of daily LIPUS at 30 mW/cm² could meaningfully shorten time to union.
A 38% reduction in healing time is not a statistical abstraction — for a patient in a cast, it means getting back to work and weight-bearing nearly two months sooner.
When you have a young, active patient with a closed or grade-I open tibial shaft fracture managed nonoperatively, LIPUS is a Level I-supported adjunct worth offering: 20 minutes per day at home, started within one week of injury, continued up to 20 weeks.
The Cox regression data are reassuring for clinical decision-making. The benefit does not depend on age, sex, fracture pattern, or when weight-bearing starts. So you do not need to stratify patients before recommending it.
Patient selection matters. This trial enrolled only transverse, short oblique, and short spiral diaphyseal fractures with a gap under 5 mm and displacement under 50%. Do not extrapolate to comminuted, metaphyseal, or higher-grade open fractures. Those were explicitly excluded.