BONE STIMULATOR
Low-intensity pulsed ultrasound (LIPUS) should not be used for nonoperative management of acute mid-shaft clavicle fracture as it does not result in accelerated healing or lower rates of non-union.

Rationale

There is limited evidence on treatment of clavicle fracture using low intensity pulsed ultrasound. One high-quality placebo-controlled trial (Lubbert 2008) was reviewed which investigated use of LIPUS in patients with acute midshaft clavicle fracture. It found that there was no difference in fracture healing, functional outcomes, or pain outcomes between the two groups.

Benefits/Harms of Implementation

There is no obvious benefit of low intensity pulsed ultrasound. However, it can cause unnecessary inconvenience to patients.

Outcome Importance

Clavicle fractures can be treated nonoperatively or surgically based on standard of care. Ultrasound usage is not necessary.

Cost Effectiveness/Resource Utilization

Low intensity pulsed ultrasound adds to significant financial burden to patient. Based on the evidence it doesn’t seem to be cost effective.

Acceptability

There is no issue with acceptability of the outcome.

Feasibility

There is no issue with feasibility of the outcome.

Future Research

Further research is required in this area, as only one high-quality study was identified through the literature review. It’s possible that medium intensity ultrasound may have different outcomes. High quality studies in different age groups could shed some light on the possibility that ultrasound may have different effects in young versus older patients.