Low-intensity pulsed ultrasound treatment as an alternative to vascular bone graft surgery for a 5-year-long ulnar non-union in a patient with haemochromatosis.


Author: Povlsen SD1, Povlsen B2.

Affiliation: 1Faculty of Medicine, Imperial College London, London, UK. 2Faculty of Medicine, London Hand Clinic, London, UK.
Conference/Journal: BMJ Case Rep.
Date published: 2015 Nov 3
Other:
 Volume ID: 2015   ,  Special Notes: doi: 10.1136/bcr-2015-211950   ,  Word Count: 153  
    Abstract

We present the case of a 75-year-old woman with haemochromatosis who developed a 5-year-long right ulnar non-union after a shortening osteotomy to correct a malunited Colles' fracture. Standard surgical treatment for ulnar non-unions was attempted on 19 March 2008 and again on 20 April 2009, but the non-union persisted on 8 May 2012, as confirmed by CT scan. Vascular bone grafting and refixation was then considered, but the patient declined this extensive operation, instead choosing to try non-invasive low-intensity pulsed ultrasound treatment with an Exogen device. Just 4 months later, complete union as confirmed by CT scan was achieved. This is the first case demonstrating the efficacy of ultrasound treatment for long-standing non-unions resistant to surgery in patients with haemochromatosis, a disorder where iron deposition can provide suboptimal circumstances for bone healing. Our finding suggests that low-intensity pulsed ultrasound devices could be used as a first-line treatment for stable non-unions instead of revision surgery.

2015 BMJ Publishing Group Ltd.

PMID: 26531737