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NICE guidance says low-intensity pulsed ultrasound adequate for fracture healing

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Current evidence concerning the safety of low-intensity pulsed ultrasound and its efficacy for promoting fracture healing shows that it sufficiently delivers a clinical benefit and reduces fracture healing time, according to interventional procedure guidance 374 issued in December 2010 by the United Kingdom’s National Institute for Health and Clinical Excellence or NICE.

The document, directed at health care professionals, described nonunions as the type of fracture-healing situations that may require and benefit from prolonged management with low-intensity pulsed ultrasound. It outlined the noninvasive nature of the ultrasound procedure, which involves placing an ultrasound probe over a nonunion site for about 20 minutes daily.

Patients at risk

“Today’s guidance from NICE shows that low-intensity pulsed ultrasound is safe and has clear clinical benefits for patients with fractured bones, especially those with or at risk of complications. I would encourage health care professionals to utilize this important technology to promote faster and more reliable healing of their injuries,” Angus D. MacLean, FRCS, consultant orthopaedic surgeon at Glasgow Royal Infirmary, Scotland, stated in a press release from Smith & Nephew.

Smith & Nephew, in York, United Kingdom, manufactures EXOGEN — a low-intensity pulsed ultrasound system sold in Europe for the indications of healing fractures, including those with delayed or stopped healing.

The efficacy section of the NICE document cited six clinical studies involving more than 1,900 patients, and the safety section of the document cited two studies in support of the guidance’s statement of efficacy and the lack of any major safety issues with the procedure, according to the guidance.

Specialist advisers

In 2010 a NICE advisory committee met to consider the evidence and make recommendations for this technology. It also consulted with specialist advisers familiar with bone fracture healing before making their recommendations, including the British Orthopaedic Association and British Limb Reconstruction Society, based on information at the NICE website.

On July 26, 2010, NICE released its provisional recommendations concerning pulsed ultrasound technology for bone healing.

NICE recommendations apply to England, Wales, Scotland and Northern Ireland.

Reference:

NICE Interventional Procedures Guidance 374 on “Low-intensity pulsed ultrasound to promote fracture healing.” www.nice.org.uk/IPG374.