• Arch Orthop Trauma Surg · Nov 2023

    Multicenter Study

    Multicenter consensus statements on the use of low-intensity pulsed ultrasound (LIPUS) in Hand Surgery.

    • Victoria Franziska Struckmann, Annette Stolle, Arne Böcker, Stefan Hagl, Ulrich Kneser, and Leila Harhaus.
    • Department of Hand, Plastic and Reconstructive Surgery, Burn Center, Department of Hand and Plastic Surgery of Heidelberg University, BG Trauma Center, Ludwigshafen, Germany. vfs@me.com.
    • Arch Orthop Trauma Surg. 2023 Nov 1; 143 (11): 696569726965-6972.

    ObjectiveThe purpose of this agreement was to establish consensus statements on the use of low-intensity pulsed ultrasound (LIPUS) in hand surgery.MethodsBased on Delphi consensus methodology, a preliminary list of questions on the use of LIPUS in hand surgery was developed by an interdisciplinary team of hand and plastic surgeons as well as psychologists and experts from communications science. Based on these, questionnaires were invented and a total of three Delphi rounds have been conducted. Delphi panelists consisted of 11 German hand surgeons with a mean experience in hand surgery of 15 years (7-23 years). Questions and statements were revised during this process, resulting in a consensus at the end of round three.ResultsAfter three Delphi rounds, the following recommendations could be derived. LIPUS can be applied for impaired fracture healing of the digits, metacarpals, carpal bones as well as a prophylactic procedure in order to avoid further revision surgery. LIPUS therapy can be useful in addition to revision surgery for delayed union and non-unions. In the case of certain risk factors (replantation, revascularization, osteoporosis, smoking), it can be applied directly postoperatively in order to prevent impaired fracture healing. It should be applied for 90-120 days.ConclusionThere is a consensus among German hand surgeons, when and how LIPUS can be applied for improving fracture healing of the hand. Randomized controlled trials with direct comparison of fracture treatment with and without LIPUS are needed to support these statements with objective data.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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