Mechanical means to improve bone strength: ultrasound and vibration.

Not all fractures heal well. One method that has been used to improve fracture healing is low-intensity pulsed ultrasound (LIPUS). LIPUS has been US Food and Drug Administration approved for several years, and some preclinical and clinical evidence indicates that fracture healing can be improved by this technique, which appears to be generally safe. There are several suggested mechanisms of action of LIPUS. Clinical studies generally support its usefulness in accelerating fracture healing. A less-established modality is whole body vibration (WBV), which appears to stimulate bone and muscle growth while suppressing adipogenesis in animal studies. Early studies in humans, including some in children with disabilities, suggest that WBV holds promise as a technique for reducing fracture risk. The exact place of WBV in preventing fracture remains to be established.