{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:04:26Z","timestamp":1756425866133,"version":"3.44.0"},"reference-count":16,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2015,10,15]]},"abstract":"<jats:p>We present the case of a 75-year-old woman with haemochromatosis who developed a 5-year-long right ulnar non-union after a shortening osteotomy to correct a malunited Colles\u2019 fracture. Standard surgical treatment for ulnar non-unions was attempted on 19 March 2008 and again on 20 April 2009, but the non-union persisted on 8 May 2012, as confirmed by CT scan. Vascular bone grafting and refixation was then considered, but the patient declined this extensive operation, instead choosing to try non-invasive low-intensity pulsed ultrasound treatment with an Exogen device. Just 4\u2005months later, complete union as confirmed by CT scan was achieved. This is the first case demonstrating the efficacy of ultrasound treatment for long-standing non-unions resistant to surgery in patients with haemochromatosis, a disorder where iron deposition can provide suboptimal circumstances for bone healing. Our finding suggests that low-intensity pulsed ultrasound devices could be used as a first-line treatment for stable non-unions instead of revision surgery.<\/jats:p>","DOI":"10.1136\/bcr-2015-211950","type":"journal-article","created":{"date-parts":[[2016,2,15]],"date-time":"2016-02-15T13:47:30Z","timestamp":1455544050000},"page":"bcr2015211950","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Low-intensity pulsed ultrasound treatment as an alternative to vascular bone graft surgery for a 5-year-long ulnar non-union in a patient with haemochromatosis"],"prefix":"10.1136","volume":"2015","author":[{"given":"Sebastian Daniel","family":"Povlsen","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Imperial College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo","family":"Povlsen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, London Hand Clinic, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2015,11,3]]},"reference":[{"key":"2025082804360240000_2015.nov03_1.bcr2015211950.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2011.10.014"},{"key":"2025082804360240000_2015.nov03_1.bcr2015211950.2","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-008-0701-4"},{"key":"2025082804360240000_2015.nov03_1.bcr2015211950.3","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-005-1934-0"},{"key":"2025082804360240000_2015.nov03_1.bcr2015211950.4","doi-asserted-by":"publisher","DOI":"10.1007\/s10534-006-9000-8"},{"key":"2025082804360240000_2015.nov03_1.bcr2015211950.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.toxlet.2009.08.023"},{"key":"2025082804360240000_2015.nov03_1.bcr2015211950.6","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-010-1456-2"},{"key":"2025082804360240000_2015.nov03_1.bcr2015211950.7","first-page":"377","article-title":"Effects of iron overload on bone remodelling in pigs","volume":"116","author":"de Vernejoul","year":"1984","journal-title":"Am J Pathol"},{"key":"2025082804360240000_2015.nov03_1.bcr2015211950.8","first-page":"614","article-title":"Causes and treatment of non-union in fractures of the radius and ulna","volume":"44B","author":"de Buren","year":"1962","journal-title":"JBJS"},{"key":"2025082804360240000_2015.nov03_1.bcr2015211950.9","unstructured":"Cleveland KB . Chapter 56\u2014Delayed union and nonunion of fractures. Canale & Beaty: Campbell's Operative Orthopaedics. 11th edn e-book. Mosby, An Imprint of Elsevier, 2007."},{"issue":"(Suppl 1)","key":"2025082804360240000_2015.nov03_1.bcr2015211950.10","doi-asserted-by":"crossref","first-page":"S41","DOI":"10.1016\/j.injury.2006.02.040","article-title":"Vascularised bone grafts for the management of non-union","volume":"37","author":"Soucacos","year":"2006","journal-title":"Injury"},{"key":"2025082804360240000_2015.nov03_1.bcr2015211950.11","doi-asserted-by":"publisher","DOI":"10.1359\/jbmr.2001.16.4.671"},{"key":"2025082804360240000_2015.nov03_1.bcr2015211950.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2010.03.014"},{"key":"2025082804360240000_2015.nov03_1.bcr2015211950.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2005.01.013"},{"key":"2025082804360240000_2015.nov03_1.bcr2015211950.14","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-200401000-00044"},{"key":"2025082804360240000_2015.nov03_1.bcr2015211950.15","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-200110000-00012"},{"key":"2025082804360240000_2015.nov03_1.bcr2015211950.16","unstructured":"EXOGEN ultrasound bone healing system for long bone fractures with non-union or delayed healing. NICE medical technology guidance [MTG12]. 2013. https:\/\/www.nice.org.uk\/guidance\/mtg12 (accessed 28 Jun 2015)."}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2015-211950","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T11:36:11Z","timestamp":1756380971000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2015-211950"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,11,3]]},"references-count":16,"alternative-id":["10.1136\/bcr-2015-211950"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2015-211950","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2015,11,3]]}}}