Low intensity pulsed ultrasonography for fractures: systematic review of randomised controlled trials.
Low intensity pulsed ultrasonography for fractures: systematic review of randomised controlled trials.
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DOI：
10.1136/bmj.b351
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发表时间：
2009-02-27
期刊：
影响因子：
--
通讯作者：
Guyatt GH
中科院分区：
文献类型：
--
作者：
Busse JW;Kaur J;Mollon B;Bhandari M;Tornetta P 3rd;Schünemann HJ;Guyatt GH
目的探讨低强度脉冲超声在骨折愈合中的作用。设计随机对照试验的系统评价。数据来源：CINAHL、Embase、Medline、HealthSTAR和对照试验科克伦中心登记系统的无语言限制的电子文献检索，从数据库建立到2008年9月10日。回顾方法：符合条件的研究是随机对照试验，招募任何类型的骨折患者，并将他们随机分配到低强度脉冲超声或对照组。两名评审员独立地同意资格;三名评审员独立地评估方法学质量并提取结果数据。纳入所有结局，并在可能时进行荟萃分析。结果纳入了13项随机试验，其中5项评估了对患者重要的结局。来自一项试验的中等质量证据发现，低强度脉冲超声对保守治疗的新鲜锁骨骨折的功能恢复没有影响;而来自三项试验的低质量证据表明，非手术治疗的新鲜骨折受益（更快的影像学愈合时间平均为36.9%，95%置信区间为25.6%至46.0%）。一项试验提供了中等质量的证据，表明低强度脉冲超声对非手术治疗的应力性骨折恢复功能没有影响。三项试验提供了非常低质量的证据，证明牵张成骨后功能改善加快。一项试验提供了低质量的证据，证明低强度脉冲超声检查有助于加速采用植骨治疗的已建立骨不连的愈合。四项试验提供了低质量的证据，加速手术治疗的新鲜骨折愈合。结论低强度脉冲超声对骨折愈合影响的证据是中等至极低质量的，并提供了相互矛盾的结果。虽然总体结果是有希望的，建立低强度脉冲超声在骨折管理中的作用需要大型的盲法试验，直接解决患者的重要结果，如恢复功能。
Objective To determine the efficacy of low intensity pulsed ultrasonography for healing of fractures. Design Systematic review of randomised controlled trials. Data sources Electronic literature search without language restrictions of CINAHL, Embase, Medline, HealthSTAR, and the Cochrane Central Registry of Controlled Trials, from inception of the database to 10 September 2008. Review methods Eligible studies were randomised controlled trials that enrolled patients with any kind of fracture and randomly assigned them to low intensity pulsed ultrasonography or to a control group. Two reviewers independently agreed on eligibility; three reviewers independently assessed methodological quality and extracted outcome data. All outcomes were included and meta-analyses done when possible. Results 13 randomised trials, of which five assessed outcomes of importance to patients, were included. Moderate quality evidence from one trial found no effect of low intensity pulsed ultrasonography on functional recovery from conservatively managed fresh clavicle fractures; whereas low quality evidence from three trials suggests benefit in non-operatively managed fresh fractures (faster radiographic healing time mean 36.9%, 95% confidence interval 25.6% to 46.0%). A single trial provided moderate quality evidence suggesting no effect of low intensity pulsed ultrasonography on return to function among non-operatively treated stress fractures. Three trials provided very low quality evidence for accelerated functional improvement after distraction osteogenesis. One trial provided low quality evidence for a benefit of low intensity pulsed ultrasonography in accelerating healing of established non-unions managed with bone graft. Four trials provided low quality evidence for acceleration of healing of operatively managed fresh fractures. Conclusion Evidence for the effect of low intensity pulsed ultrasonography on healing of fractures is moderate to very low in quality and provides conflicting results. Although overall results are promising, establishing the role of low intensity pulsed ultrasonography in the management of fractures requires large, blinded trials, directly addressing patient important outcomes such as return to function.
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DOI：
10.1016/j.apmr.2003.12.040
发表时间：
2004-10-01
影响因子：
4.3
作者：
Busse, JW;Bhandari, M
通讯作者：
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影响因子：
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影响因子：
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2
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