{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:51:09Z","timestamp":1787755869452,"version":"build-2784847793"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"17","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,9,4]]},"abstract":"<jats:sec>\n                    <jats:title>Update<\/jats:title>\n                    <jats:p>This article was updated on September 4, 2024 because of a previous error, which was discovered after the preliminary version of the article was posted online. In the Note listing the members of the Wrist and Elbow Research Group of Canada, the text that had read \u201cThomas T. Goetz, MD, FRCSC\u201d now reads \u201cThomas J. Goetz, MD, FRCSC\u201d.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The primary goal after open reduction and internal fixation of an established scaphoid nonunion is to achieve union. Low-intensity pulsed ultrasound (LIPUS) has been reported to increase the rate of union and to decrease the time to union for multiple fractures and nonunions in clinical and animal models. The evidence for LIPUS in the treatment of scaphoid nonunion, however, is sparse. The aim of this study was to assess whether active LIPUS (relative to sham LIPUS) accelerates the time to union following surgery for scaphoid nonunion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Adults with a scaphoid nonunion indicated for surgery were recruited for a multicenter, prospective, double-blinded randomized controlled trial. After surgery, patients self-administered activated or sham LIPUS units beginning at their first postoperative visit. The primary outcome was the time to union on serial computed tomography (CT) scans starting 6 to 8 weeks postoperatively. Secondary outcomes included patient-reported outcome measures, range of motion, and grip strength.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 142 subjects completed the study (69 in the active LIPUS group and 73 in the sham group). The average age was 27 years, and the cohort was 88% male. There was no difference in time to union (p = 0.854; hazard ratio, 0.965; 95% confidence interval, 0.663 to 1.405). Likewise, there were no differences between the active LIPUS and sham groups with respect to any of the secondary outcomes, except for wrist flexion at baseline (p = 0.008) and at final follow-up (p = 0.043).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Treatment with LIPUS had no effect on reducing time to union in patients who underwent surgical fixation of established scaphoid nonunions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level I<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.23.00783","type":"journal-article","created":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T14:13:52Z","timestamp":1719843232000},"page":"1573-1582","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":10,"title":["Low-Intensity Pulsed Ultrasound Versus Sham in the Treatment of Operatively Managed Scaphoid Nonunions"],"prefix":"10.2106","volume":"106","author":[{"given":"Neil J.","family":"White","sequence":"first","affiliation":[{"name":"Section of Orthopedics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada"},{"name":"The South Campus Research Unit for Bone and Soft Tissue (SCRUBS), Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7476-3316","authenticated-orcid":false,"given":"Ethan D.","family":"Patterson","sequence":"additional","affiliation":[{"name":"The South Campus Research Unit for Bone and Soft Tissue (SCRUBS), Calgary, Alberta, Canada"},{"name":"Queen\u2019s University School of Medicine, Kingston, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2123-0935","authenticated-orcid":false,"given":"Gurpreet S.","family":"Dhaliwal","sequence":"additional","affiliation":[{"name":"Section of Orthopedics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada"},{"name":"The South Campus Research Unit for Bone and Soft Tissue (SCRUBS), Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8786-9021","authenticated-orcid":false,"given":"Kevin A.","family":"Hildebrand","sequence":"additional","affiliation":[{"name":"Section of Orthopedics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada"},{"name":"The South Campus Research Unit for Bone and Soft Tissue (SCRUBS), Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"WECAN","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,7,1]]},"reference":[{"issue":"2","key":"bib1-20250430","doi-asserted-by":"crossref","first-page":"E41","DOI":"10.1097\/TA.0b013e31822458e8","article-title":"Scaphoid fracture epidemiology","volume":"72","author":"Duckworth","year":"2012","journal-title":"J Trauma Acute Care Surg."},{"issue":"3","key":"bib2-20250430","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1016\/j.jhsa.2005.10.019","article-title":"The outcomes and complications of 1,2-intercompartmental supraretinacular artery pedicled vascularized bone grafting of scaphoid nonunions","volume":"31","author":"Chang","year":"2006","journal-title":"J Hand Surg Am."},{"issue":"6","key":"bib3-20250430","doi-asserted-by":"crossref","first-page":"988","DOI":"10.1016\/j.jhsa.2008.04.026","article-title":"Treatment of scaphoid fractures and nonunions","volume":"33","author":"Kawamura","year":"2008","journal-title":"J Hand Surg Am."},{"issue":"1-6","key":"bib4-20250430","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1080\/2000656X.2021.2024439","article-title":"Cast selection and non-union rates for acute scaphoid fractures treated conservatively: a systematic review and meta-analysis","volume":"57","author":"Siotos","year":"2023","journal-title":"J Plast Surg Hand Surg."},{"issue":"4","key":"bib5-20250430","doi-asserted-by":"crossref","first-page":"504","DOI":"10.2106\/00004623-198466040-00003","article-title":"The natural history of scaphoid non-union","volume":"66","author":"Mack","year":"1984","journal-title":"J Bone Joint Surg Am."},{"issue":"3","key":"bib6-20250430","doi-asserted-by":"crossref","first-page":"428","DOI":"10.2106\/00004623-198567030-00013","article-title":"The natural history of scaphoid non-union. 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