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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.

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.
AuthorsSebastian Daniel Povlsen, Bo Povlsen
JournalBMJ case reports (BMJ Case Rep) Vol. 2015 (Nov 03 2015) ISSN: 1757-790X [Electronic] England
PMID26531737 (Publication Type: Case Reports, Journal Article)
Copyright2015 BMJ Publishing Group Ltd.
Topics
  • Aged
  • Chronic Disease
  • Female
  • Fractures, Ununited (etiology, therapy)
  • Hemochromatosis (complications)
  • Humans
  • Ulna Fractures (complications, surgery)
  • Ultrasonic Therapy
  • Ultrasonic Waves

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