Cochrane · systematic review · CD008579
Ultrasound and shockwave therapy for acute fractures in adults
Searle, HKC, Lewis, SR, Coyle, C, et al. · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library
Bone, Joint and Muscle TraumaAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
14
current version
GRADE rated
8
No studies
6
Included studies
NR
No studies 6 · 42.9%Ungraded 0 · 0%Very low 6 · 42.9%Low 1 · 7.1%Moderate 1 · 7.1%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Low‐intensity pulsed ultrasound compared to control for acute fractures in adults
Population: acute fractures in adults; included studies assessed effects in complete upper limb fractures (distal radius, clavicle, scaphoid, mandibular, rib), complete lower limb fractures (fifth metatarsal, tibia, femur, lateral malleolus) and stress fractures
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Participant‐reported quality of life (medium term) QoL measured using SF‐36 PCS ranging from 0 to 100; high scores indicate better quality of life Low‐intensity pulsed ultrasound vs control | no estimate extracted | 3 studies · 393 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Quantitative functional improvement Using PROMs Low‐intensity pulsed ultrasound vs control | no estimate extracted | NR | No studies |
Time to return to normal activities (work) Number of days Low‐intensity pulsed ultrasound vs control | no estimate extracted | 2 studies · 370 participants | Low Downgraded: risk of bias, imprecision |
Time to fracture union (days) Low‐intensity pulsed ultrasound vs control | no estimate extracted | 11 studies · 887 participants | Very low Downgraded: risk of bias, inconsistency |
Pain (short term): using VAS (range 0 to 10); higher values indicate worse pain Low‐intensity pulsed ultrasound vs control | no estimate extracted | 2 studies · 148 participants | Very low Downgraded: imprecision, inconsistency |
Delayed or non‐union (medium term) Low‐intensity pulsed ultrasound vs control | RR 1.25 [0.5, 3.09] | 7 studies · 746 participants | Moderate Downgraded: imprecision |
Adverse events Reported as skin irritation Low‐intensity pulsed ultrasound vs control | RR 0.94 [0.06, 14.65] | 1 study · 101 participants | Very low Downgraded: risk of bias, imprecision |
Extracorporeal shock wave therapy compared to control for acute fractures in adults
Population: adolescents and adults with acute fractures in tibia and femur
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Participant‐reported quality of life Extracorporeal shock wave therapy vs control | no estimate extracted | NR | No studies |
Quantitative functional improvement Extracorporeal shock wave therapy vs control | no estimate extracted | NR | No studies |
Time to return to normal activities Extracorporeal shock wave therapy vs control | no estimate extracted | NR | No studies |
Time to fracture union Extracorporeal shock wave therapy vs control | no estimate extracted | NR | No studies |
Pain (medium term): using VAS (range 0 to 10); higher values indicate worse pain Extracorporeal shock wave therapy vs control | no estimate extracted | 1 study · 57 participants | Very low Downgraded: risk of bias, imprecision |
Delayed or non‐union (medium term) Extracorporeal shock wave therapy vs control | RR 0.56 [0.15, 2.01] | 1 study · 57 participants | Very low Downgraded: risk of bias, imprecision |
Adverse events Extracorporeal shock wave therapy vs control | no estimate extracted | NR | No studies |