SRS292 - Exogen efficacy in patients having non-union of fractures- a case series study for patients treated at UHB trust

Abstract Introduction Non-union following fracture remains a challenging problem, often requiring re-operation. Low-intensity pulsed ultrasound (EXOGEN) is a non-invasive treatment, which has been proposed as an adjunct to stimulate bone healing. Aim To evaluate its efficacy in patients with established fracture non-union treated within a large tertiary trauma centre. Methods We retrospectively reviewed patients prescribed EXOGEN for fracture non-union at University Hospitals Birmingham NHS FT between 2021 and 2025. Data included demographics, fracture site, response to EXOGEN, and the need for subsequent surgical intervention. The average number of cycles advised to them were of 150. The patients were usually reviewed in about 8–12 weeks’ time. Treatment success was defined as radiological and/or clinical evidence of healing with avoidance of further surgery. Results A total of 48 patients were studied receiving EXOGEN for fracture non-union. Of these, 18 patients (37.5%) achieved union following treatment, while 9 patients (18.8%) demonstrated no response. One patient (2.1%) showed partial progression of healing. Seven patients (14.6%) proceeded to surgical fixation despite EXOGEN therapy. The remainder were either ongoing in treatment or had incomplete follow-up data. Fracture sites included the humerus, radius, tibia, pelvis and ankle. Conclusions EXOGEN demonstrated union in over one-third of patients with fracture non-union at our centre, potentially reducing the need for revision surgery. However, a significant proportion required surgical intervention or failed to achieve union. These findings highlight the role of EXOGEN as a useful adjunct in selected patients, while underscoring the need for larger controlled studies to establish definitive efficacy.