This systematic review and meta-analysis evaluates LIPUS as a nonsurgical treatment for established fracture nonunions. It pools data from 13 studies (1441 nonunions) to estimate overall heal rate and identify factors that predict success.
Established nonunions carry no expectation of spontaneous healing, and revision surgery — while often effective. Is technically demanding and carries meaningful complication risk, particularly in medically complex patients.
This meta-analysis gives you a number to use in informed consent conversations: LIPUS achieves roughly 80% healing across all nonunion types and anatomical sites, making it a credible nonsurgical alternative when surgery is high risk or the patient declines reoperation.
When you see a hypertrophic nonunion in a patient who is elderly, on anticoagulation, or otherwise a poor surgical candidate, LIPUS is a defensible first-line choice. Starting within 6 months of the last procedure maximizes the chance of success.
Atrophic nonunions respond less well. The odds of healing are half those of hypertrophic nonunions. So for biologically inactive atrophic cases, surgical debridement and grafting remain the preferred approach.
This systematic review and meta-analysis evaluates LIPUS as a nonsurgical treatment for established fracture nonunions. It pools data from 13 studies (1441 nonunions) to estimate overall heal rate and identify factors that predict success.
Established nonunions carry no expectation of spontaneous healing, and revision surgery — while often effective. Is technically demanding and carries meaningful complication risk, particularly in medically complex patients.
This meta-analysis gives you a number to use in informed consent conversations: LIPUS achieves roughly 80% healing across all nonunion types and anatomical sites, making it a credible nonsurgical alternative when surgery is high risk or the patient declines reoperation.
When you see a hypertrophic nonunion in a patient who is elderly, on anticoagulation, or otherwise a poor surgical candidate, LIPUS is a defensible first-line choice. Starting within 6 months of the last procedure maximizes the chance of success.
Atrophic nonunions respond less well. The odds of healing are half those of hypertrophic nonunions. So for biologically inactive atrophic cases, surgical debridement and grafting remain the preferred approach.