Plain language summary Ultrasound and shockwave treatment for recently broken bones in adults Key messages ‐ The benefits of ultrasound and shockwave treatment in improving people’s quality of life after a broken bone are unclear. ‐ Ultrasound therapy probably does not make a difference to how well the bone heals. ‐ Shockwave therapy may very slightly reduce pain one month after injury in people who have a broken bone in their thigh or shin bone. However, it is unlikely that this reduction in pain will be to a meaningful amount. ‐ More well‐designed, large studies are needed to see if ultrasound and shockwave treatment help broken bones to heal. Why is treating recently broken bones important? Sometimes, broken bones take longer to heal or may not even fully heal. This can reduce people’s quality of life, and increase the time needed to return to their normal activities (such as work). A treatment that can help bone to heal would be beneficial to ensure broken bones heal. Sound waves may help broken bones to form new bone by stimulating the area. People can be treated using sound waves by ultrasound or shockwave therapy. Both treatments involve placing a special device in contact with the skin overlying the fracture site for around 20 minutes on a daily basis. Ultrasound therapy using low‐energy sound waves, compared to shockwave therapy which uses high‐energy sound waves that feel like vibrations on the area that it is applied to. What did we want to find out? We wanted to find out if ultrasound or shockwave therapy help recently broken bones to heal more quickly. We also wanted to find out if it improved people’s quality of life, and function of the injured bone (for example, whether people are able to perform the same day‐to‐day activities, like walking or brushing their hair, as before their injury), reduced pain and helped people get back to normal activities (such as work) more quickly. What did we do? We searched for studies in people who had a recent broken bone. Studies compared: ‐ low or high intensity ultrasound with no treatment or a sham therapy. Sham therapy used a device that looked like ultrasound or shockwave but was not real. ‐ shockwave therapy with no treatment or sham therapy. We compared and summarised their results, and rated our confidence in the evidence based on factors such as study methods and sizes. What did we find? We found 21 studies, including 1517 people with recently broken bones. Twenty studies evaluated low‐intensity ultrasound treatment and one study evaluated shockwave therapy. No studies evaluated high‐intensity ultrasound. The biggest study was in 501 people, with the smallest study in 20 people. Studies were conducted in ten different countries around the world. Key results For ultrasound treatment, we are unsure if there is an effect on people’s quality of life, time for the broken bone to heal, pain or whether this treatment had any side effects. This treatment probably makes no difference to the number of bones that heal much later than we expect or do not heal at all, and it may not make a difference to the time it takes for people to return to work. We found no ultrasound studies that reported findings for function. We found that shockwave treatment may very slightly reduce pain in people who had broken bones in their thigh or shin, but not to a meaningful amount. We are unsure if shockwave treatment reduces the number of bones that heal much later than we expect or that do not heal at all. No shockwave studies reported findings for quality of life, function, time to return to work, or time for the broken bone to heal. Main limitations Most of the studies were small, and did not report all the findings we were interested in. Many people did not complete the study, and we do not know the results for these missing people. It was possible that some people were aware what treatment they were receiving when a sham device was not used. We also found that there were a lot of differences in findings between different studies. Overall, this meant that we are not confident in most of our findings. How up to date is this evidence? This review updates our previous review. The evidence is up to date to March 2022.
【저자키워드】 Adult, humans, Adolescent, Pain, Ultrasonography, extracorporeal shockwave therapy, randomized controlled trials as topic, Fractures, Stress, High-Energy Shock Waves,