Low-intensity pulsed ultrasound and pulsed electromagnetic field in the treatment of tibial fractures: a systematic review

A total of 8 placebo-controlled randomized controlled trials (RCTs) investigating the effects of either low-intensity pulsed ultrasound (LIPUS; n=5 RCTs; 4 study populations) or pulsed electromagnetic field therapy (PEMF; n=3 RCTs) in tibial fracture management were included in this systematic review. All LIPUS articles investigated the effect this treatment in acute tibial fracture management while all PEMF articles investigated effect in tibial nonunion management. Results evaluating LIPUS demonstrated a significant reduction in time to union in the LIPUS-treated groups compared to placebo-treated groups in 3/4 study populations. Results on PEMF demonstrated significant differences in favour of the PEMF-treated groups compared to placebo-treated groups in 2/3 studies evaluating either union or progression towards union at follow-up time points of 12 weeks and 15 weeks though the remaining study reported no difference in union rate between groups at 24 weeks.