Low-intensity pulsed ultrasound is frequently used to treat fractures after osteosynthesis in elderly patients: A study using open data from the national database of health insurance claims of Japan

J Orthop Sci. 2021 Sep;26(5):865-869. doi: 10.1016/j.jos.2020.08.015. Epub 2020 Dec 9.

Abstract

Background: The national database of health insurance claims of Japan (NDB) includes almost all health insurance claims in Japan. Currently, we have many cases of geriatric fracture in Japan, probably due to an increase of the elderly population. The increase of geriatric fractures may influence the use of low-intensity pulsed ultrasound (LIPUS), which is used to accelerate the fracture repair process. The present state of LIPUS treatments was analyzed using the large dataset of the NDB.

Methods: The open data from the NDB that were used included receipts from April 2015 to March 2016. The total numbers of fracture treatments were counted as the sum of the claim items that were involved in fracture treatments. Two types of the insurance claim items for LIPUS treatments were counted separately: those used for delayed or non-union fractures; and those used for fractures within two weeks after osteosynthesis. Additionally, the ratio of the LIPUS treatments per the fracture treatments was calculated.

Results: In female patients, the number of LIPUS treatments for fractures early after osteosynthesis showed a large peak in the senile generation. Additionally, the ratio of LIPUS treatments early after osteosynthesis to all osteosynthesis treatments tended to increase with age in both males and females, while the ratio of the LIPUS treatments for delayed or non-union fractures to all fracture treatments decreased with age.

Conclusions: LIPUS treatments were frequently used to treat fractures early after osteosynthesis in elderly patients, probably due to the large number of fractures in the elderly population. Additionally, the ratio of LIPUS treatments early after osteosynthesis was high in both elderly female and elderly male patients, suggesting that there is a demand for early fracture repair.

MeSH terms

  • Aged
  • Female
  • Fracture Healing*
  • Humans
  • Insurance, Health
  • Japan / epidemiology
  • Male
  • Ultrasonic Therapy*
  • Ultrasonic Waves