Low intensity ultrasound treatment increases strength in a rat femoral fracture model.

Bilateral closed femoral shaft fractures were made in 22 male Long-Evans rats. In 16 animals, ultrasound was applied to one limb for 15 minutes daily 10 times within the first 14 postoperative days. The treated limbs received a 200 microseconds burst of 1.5 or 0.5 MHz sine waves repeated at 1.0 kHz at a spatial average and temporal average intensity of 30 mW/cm2. The contralateral limb of each animal served as a nontreated control. Six remaining animals with fractures and six additional animals without fractures received sham ultrasound treatment to control for the effects of anesthesia and handling. Fracture repair was evaluated on postoperative day 21 by radiography, mechanical testing in torsion, and histology. Five of 16 ultrasound-treated fractures showed obliteration of the fracture gap on radiographs, whereas none of the 28 controls did. The average maximum torque of fractures treated with either signal was 22% greater than that of the contralateral controls (p < 0.05). The stiffness of treated fractures was greater than that of control fractures, but the difference was significant only in animals treated with the 1.5 MHz signal (p < 0.02). Sham treatment did not affect repair in the control group. These results indicate that low-intensity pulsed ultrasound at either 0.5 or 1.5 MHz can accelerate fracture repair at 21 days in this highly controlled model.