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The effect of low-intensity pulsed ultrasound on callus maturation in tibial distraction osteogenesis

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Callus distraction is currently the most popular method of bone lengthening. Prolonged treatment time is one of its major problems. In this study, we investigated the effect of low-intensity pulsed ultrasound on tibial distraction osteogenesis. We managed 20 patients with tibial defects ranging from 5 cm to 8 cm with distraction osteogenesis using the Ilizarov external fixator. After the completion of distraction, ten patients received daily 20 min of low-intensity pulsed ultrasound stimulation (30 mW/cm2) onto the bone lengthening site (group A) while rigid fixation was maintained in the remaining patients (group B). All patients were followed with weekly radiographs to determine the formation of an external cortex and an intramedullary canal, at which time the fixator was removed. The mean healing index in group A was 30 (27–36) days/cm while it was 48 (42–75) days/cm in group B. In group B, one patient failed to consolidate the regenerated bone. Low-intensity pulsed ultrasound stimulation is highly effective in achieving maturation of bone and reducing time of distraction osteogenesis.


La distraction du cal est la méthode d’allongement de l’os la plus populaire actuellement. La longueur du traitement est un de ses problèmes majeurs. Nous avons étudié l’effet des ultrasons pulsés de basse intensité sur l’ostéogenèse dans la distraction tibiale.Nous avons traité 20 malades présentant un défaut tibial de 5 à 8 centimètres avec ostéogenèse de distraction utilisant un fixateur externe d’Ilizarov. Après l’achèvement de la distraction 10 malades ont reçu quotidiennement une stimulation par ultrasons (30 mW/cm2) sur l’emplacement de l’allongement osseux pendant 20 minutes (groupe A), pendant que la fixation rigide était maintenue pour le restant des malades (groupe B). Tous les malades ont été suivis avec des radiographies hebdomadaires pour déterminer la formation d’un cortex périphérique et d’un canal intramédullaire au moment ou le fixateur a été enlevé. L’index de consolidation moyen dans le groupe A était 30 (27–36) jours/cm pendant qu’il était 48 (42–75) jours/cm dans le groupe B. Dans le groupe B un malade n’a pas consolidé l’os régénéré. La stimulation par ultrasons pulsés de basse intensité est très efficace pour favoriser la maturation osseuse et réduire le temps d’ostéogenèse dans la distraction.

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Correspondence to Hani El-Mowafi.

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None of the authors received financial support for this study.

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El-Mowafi, H., Mohsen, M. The effect of low-intensity pulsed ultrasound on callus maturation in tibial distraction osteogenesis. International Orthopaedics (SICOT) 29, 121–124 (2005).

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