Pulsed Ultrasound May Be Effective for the Treatment of Rib Fractures
Pulsed ultrasound was delivered at 1 MHz, 0.5 W/cm2 for 1 min/cm2.
Pulsed ultrasound treatment may represent an effective option for the treatment of stable rib fractures, according to a recent study published in Pain Medicine.
A total of 47 patients with rib fractures were randomly assigned to receive pulsed ultrasound without emission (n=23) or pulsed ultrasound delivered at 1 MHz, 0.5 W/cm2 for 1 min/cm2 (n=24). Each participant was assessed at baseline and at 1, 3, and 6 months for bone callus healing rate, pain level, physical and work activity, pain medication intake, and adverse events. There were no significant differences between groups at baseline, with median pain level of 8.5 and 9 on a 10-point scale for patients in the control and intervention groups, respectively (P =.083).
Pain was found to be lower in participants receiving the intervention vs control ultrasound at 1 month (1.3 vs 3.0, respectively; P =.004), 3 months (0.3 vs 1.6, respectively; P =.005), and 6 months (0.2 vs 0.7, respectively; P =.025).
Participants in the intervention vs control group experienced greater bone callus consolidation at 1 month (P =.013) and 3 months (P <.001), accelerated return to physical activity by month 3 (P =.036) and accelerated work activity at 1 month (P =.001). The intervention group also had lower pain medication intake at 1 month (P =.057) and 3 months (P =.017) compared with the control group. No adverse events related to pulsed ultrasounds were reported by participants in the intervention group.
Study limitations include the exclusion of patients with severe thoracic trauma.
“[This] new noninvasive, easily applicable, low-cost, and no side effects treatment [was found to be] capable of significantly changing the outcome of patients with stable [rib fractures]…and its application should be considered as part of current treatment schemes for noncomplicated [rib fracture] to improve patient care before surgical or invasive treatments,” concluded the study authors.
Santana-Rodríguez N, Clavo B, Llontop P, et al. Pulsed ultrasounds reduce pain and disability, increasing rib fracture healing, in a randomized controlled trial [published online November 29, 2018]. Pain Med. doi: 10.1093/pm/pny224