Acute tibial fractures

Summary

Limited evidence from three randomized controlled trials provide mixed results for LIPUS treatment of acute tibial fractures compared with a placebo treatment in both operatively and nonoperatively managed injuries. One operatively managed study indicated a reduced time to healing may occur with LIPUS compared with placebo, but another operatively managed study suggested no difference between the two treatments. Both studies had relatively small sample sizes. One older study that utilized nonoperative management of the tibial fractures reported better results with LIPUS compared with the control treatment, and had larger sample sizes. The inconsistency of the evidence might be due to type II error in the smaller studies, or a real difference in some fracture groups. Additional methodologically rigorous randomized controlled trials with larger populations are necessary to establish the superiority of LIPUS treatment for treatment of acute tibial fractures.