• Kar Hao Teoh, Robert Whitham, Jenny F Wong, and Kartik Hariharan.
• Foot and Ankle Unit, Ysbyty Ystrad Fawr, Ystrad Fawr Way, Ystrad Mynach, Hengoed CF82 7EP, United Kingdom. Electronic address: kar.teoh@wales.nhs.uk.
• Foot (Edinb). 2018 Jun 1; 35: 52-55.

BackgroundThere are no studies looking at the success rate of low-intensity pulsed ultrasound (LIPUS) in fifth metatarsal fracture delayed unions to our knowledge. The aim of this study is to investigate the use of LIPUS treatment for delayed union of fifth metatarsal fractures.MethodsA retrospective review of patients who were treated with LIPUS following a delayed union of fifth metatarsal fracture was conducted over a three-year period.ResultsThere were thirty patients (9 males, 21 females) in this cohort. The average age was 39.3 years. Type 2 fractures made up 43% of our cohort. Twenty-seven (90%) patients went on to progress to union clinically and radiologically following LIPUS treatment. Smoking (p=0.014) was predictive of non-union. Assuming that there were 10 delayed unions a year and 6 went on to non-union as previously suggested by a systematic review, the cost savings of using LIPUS (90% success rate; 10 LIPUS machine and surgery for 1 non-union) vs operative intervention (surgery for 6 non-union) equates to a cost saving of £7765 a year.ConclusionThere is a role for the use of LIPUS in delayed union of fifth metatarsal fractures and can serve as an adjunct prior to consideration of surgery. The findings of this study also suggest the use of LIPUS to be a cost effective treatment modality compared to surgical management.Level Of EvidenceLevel 4.Copyright © 2018 Elsevier Ltd. All rights reserved.

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