Low-intensity pulsed ultrasound in acute multiple rib fracture-a prospective analysis, randomized controlled trial...

Low-intensity pulsed ultrasound (LIPUS) is a non-invasive modality that promotes bone healing by stimulating callus formation and enhancing regeneration. Although its efficacy in long bone fractures is well established, its role in managing acute multiple rib fractures (MRFs) remains unclear. This study aimed to investigate whether LIPUS can improve fracture healing and pain control in patients with acute MRF following thoracic trauma.

This prospective, randomized study aimed to evaluate the efficacy of LIPUS in promoting bone healing through callus formation and modifying pain patterns in patients with acute MRF. The primary objective was to determine whether LIPUS could improve fracture healing outcomes and provide superior pain control compared to conventional treatment. Between April 1, 2024 and October 31, 2024, twenty adult patients with rib fractures were enrolled and randomly assigned to one of two groups: (I) the LIPUS group (n=10), who received standard rib fracture care supplemented with LIPUS therapy; and (II) the conventional group (n=10), who received standard care alone. Clinical and demographic characteristics, outcomes, and surgical complications were assessed. The primary endpoints included the effect of LIPUS on clinical manifestations and pain control in acute MRF.

Twenty eligible patients (10 males, 10 females) were included. Demographic and clinical characteristics were comparable. The average age was lower in the LIPUS group, but not significantly (64.40±8.97 vs. 67.00±14.13 years, P=0.39). No significant differences were found in sex, body weight, height, body mass index (BMI), injury mode, or comorbidities. Hospital stay was shorter in the LIPUS group (15.40±7.00 vs. 18.00±9.36 days, P=0.16). While outcomes such as hemothorax, pneumothorax, atelectasis, and inflammation were similar, Chest Trauma Score (CTS) and Thoracic Trauma Severity Score (TTSS) were significantly higher in the LIPUS group (P=0.001). Despite initially higher pain scores, significant improvement was observed after two LIPUS sessions (P=0.001). No intensive care unit (ICU) transfers or deaths occurred.

LIPUS appears to be a viable and effective treatment option for acute MRF. It may alleviate pain, reduce complications, and improve clinical outcomes, particularly in patients with traumatic hemothorax or pneumothorax.

This study was registered with the Clinical Research Information Service (CRIS: a non-profit online registry for clinical trials and research conducted in South Korea) under the reference number KCT0010838.