Effect of Low-Intensity Pulsed Ultrasound (LIPUS) on Osteotomy

Objective: LIPUS following osteotomy has been covered by national health insurance since April 2015. We investigated the effect of LIPUS on the time period for callus formation and bone union after osteotomy of the antebrachial bone. Subjects and Methods: The subjects were 13 patients who underwent antebrachial bone osteotomy between 2010 and January 2017. Nine patients were not treated with LIPUS (L–group) and 4 patients were treated with LIPUS (L+ group). There were 8 male and 5 female patients. The mean age was 40.2-year-old in the L– group and 38.1-year-old in the L+ group. The L– group included 8 patients who were treated with radial shortening for Kienbock's disease and one patient who was treated with deformity-corrective osteotomy for acute plastic bowing, and the L+ group included 3 and 1 patient treated with each of these approaches, respectively. In the L+ group, treatment with LIPUS was initiated on the day following surgery and continued until bone union was achieved. Results: In the L– group, bone union could not be achieved in the patient with acute plastic bowing, and bone union was achieved by surgery for a false joint. In the L+ group, bone union was achieved in all patients. No complications, due to infection, CRPS, or tendon or nerve injury, occurred. The callus formation period was 88–422 days (mean: 255 days) in the L– group and 15–36 days (mean: 24 days) in the L+ group. The bone union period was 123–546 days (mean: 284.4 days) in the L– group and 77–141 days (mean: 107.5 days) in the L+ group. Both callus formation and bone union periods were significantly shorter in the L+ group compared with the L– group. Discussion: The bone union-promoting effect of LIPUS after osteotomy was investigated since its coverage by the national health insurance in 2015. The callus formation and bone union periods were markedly shorter in the L+ group compared with those in the L– group. Since no false joint developed in the group treated with LIPUS, LIPUS should be applied after osteotomy.