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NICE consults nurses on ultrasound treatment for fractures

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Nurses are being asked for their views about NICE draft guidance on the use of a device to heal fractures.

The draft medical technology guidance fully supports the use of the Exogen ultrasound bone healing system in treating long bone fractures that have failed to heal after nine months (non-union fractures). However, the success rate of using Exogen for long bone fractures with delayed healing (between three and nine months) is less clear, which is why NICE is now seeking comments on its draft guidance.

Exogen works by delivering low-intensity ultrasound waves that aim to stimulate bone healing by promoting the production of growth factors and proteins. These work to simultaneously increase the removal of old bone and the production of new bone.

Ultrasound waves are transmitted via a transducer, which is secured to the fracture site by a strap. Where patients are wearing a cast, a small hole needs to be cut so the transducer may be placed in direct contact with the skin.

Patients can administer the treatment themselves at home as the device is programmed to automatically deliver the ultrasound pulses in 20-minute sessions.

The director of the NICE centre for health technology evaluation, Professor Carole Longson, said that using Exogen clearly resulted in high rates of healing for long bone fractures with non-union, with potential savings to the NHS of £1,164 per patient compared to standard treatment, which would involve surgery.

However, she added: “Whilst there was some evidence that Exogen can improve healing in fractures which have not healed after approximately three months, there were uncertainties about the rate at which healing progresses and whether surgery would otherwise be needed. The cost modelling was therefore complex, and the case for routine adoption in the NHS could not be convincingly made. We welcome comments on the draft guidance as part of the current consultation.”

The consultation closes on 12 September.

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