Fractures that are slow or fail to heal when compared against normal timeframes are called “non-union fractures”. Non-union after a fracture is not uncommon and previously there was no treatment after optimal surgical alignment other than allowing time for healing. However, time was no guarantee that a non-uniting fracture would eventually heal.
Historically, not a lot could be done in terms of treatment to expedite bone healing after a fracture other than ensuring nutritional optimisation and sufficient rest. In most cases this would take 6-12 weeks, but in some cases complications, such as the injured party being a smoker or on long term anti-inflammatories, prevent healing. This has all changed with a new treatment, called Exogen
There is now evidence to support the use of ultrasound to enhance bone healing for both fresh fractures and non-uniting fractures – using an Exogen machine.
The low intensity ultrasound device “Exogen” was pioneered by Smith & Nephew and is now owned by Bioventus. In the beginning the device was only available for those in the sporting arena, but is now available both within the NHS and privately. Research has shown it can accelerate healing times by 38% for fresh fractures and achieve an 86% heal rate for non-unions. This evidence is supported by the National Institute for Health and Care Excellence ( NICE) and is helping save the NHS on average over £1000 per patient.
How does it work?
The low intensity ultrasound device sends ultrasound waves through the skin and the soft tissue to reach the fracture. The ultrasound activates cell surface mechanoreceptors called “integrins” which in turn initiate an intracellular cascade leading to an increase in proteins, genes, enzymes and growth factors critical to bone healing.
The device itself is used daily for about twenty minutes. It can be applied and used while fractures are still in plaster provided a window is drilled out of the plaster for the machine to slot into.
To learn more about low intensity pulsed ultrasound to promote bone healing please follow the links below: