Abstract：
OBJECTIVE: The purpose of this agreement was to establish consensus statements on the use of low-intensity pulsed ultrasound (LIPUS) in hand surgery.
METHODS: Based on Delphi consensus methodology, a preliminary list of questions on the use of LIPUS in hand surgery was developed by an interdisciplinary team of hand and plastic surgeons as well as psychologists and experts from communications science. Based on these, questionnaires were invented and a total of three Delphi rounds have been conducted. Delphi panelists consisted of 11 German hand surgeons with a mean experience in hand surgery of 15 years (7-23 years). Questions and statements were revised during this process, resulting in a consensus at the end of round three.
RESULTS: After three Delphi rounds, the following recommendations could be derived. LIPUS can be applied for impaired fracture healing of the digits, metacarpals, carpal bones as well as a prophylactic procedure in order to avoid further revision surgery. LIPUS therapy can be useful in addition to revision surgery for delayed union and non-unions. In the case of certain risk factors (replantation, revascularization, osteoporosis, smoking), it can be applied directly postoperatively in order to prevent impaired fracture healing. It should be applied for 90-120 days.
CONCLUSIONS: There is a consensus among German hand surgeons, when and how LIPUS can be applied for improving fracture healing of the hand. Randomized controlled trials with direct comparison of fracture treatment with and without LIPUS are needed to support these statements with objective data.
METHODS: Based on Delphi consensus methodology, a preliminary list of questions on the use of LIPUS in hand surgery was developed by an interdisciplinary team of hand and plastic surgeons as well as psychologists and experts from communications science. Based on these, questionnaires were invented and a total of three Delphi rounds have been conducted. Delphi panelists consisted of 11 German hand surgeons with a mean experience in hand surgery of 15 years (7-23 years). Questions and statements were revised during this process, resulting in a consensus at the end of round three.
RESULTS: After three Delphi rounds, the following recommendations could be derived. LIPUS can be applied for impaired fracture healing of the digits, metacarpals, carpal bones as well as a prophylactic procedure in order to avoid further revision surgery. LIPUS therapy can be useful in addition to revision surgery for delayed union and non-unions. In the case of certain risk factors (replantation, revascularization, osteoporosis, smoking), it can be applied directly postoperatively in order to prevent impaired fracture healing. It should be applied for 90-120 days.
CONCLUSIONS: There is a consensus among German hand surgeons, when and how LIPUS can be applied for improving fracture healing of the hand. Randomized controlled trials with direct comparison of fracture treatment with and without LIPUS are needed to support these statements with objective data.
摘要：
目的：该协议的目的是就手外科中使用低强度脉冲超声（LIPUS）建立共识声明。
方法：基于德尔菲共识方法，关于LIPUS在手外科中使用的初步问题清单是由手外科和整形外科医生以及心理学家和传播学专家组成的跨学科团队开发的。基于这些,调查问卷被发明出来，总共进行了三次德尔菲轮。Delphi小组成员由11名德国手外科医师组成，他们的手外科经验平均为15年（7-23年）。在此过程中修改了问题和声明，在第三轮结束时达成共识。
结果：经过三轮Delphi，可以得出以下建议。LIPUS可用于手指骨折愈合受损，掌骨，腕骨以及预防性程序，以避免进一步的翻修手术。除了用于延迟愈合和不愈合的翻修手术外，LIPUS治疗也是有用的。在某些危险因素的情况下(再植，血运重建,骨质疏松,吸烟)，它可以在术后直接应用，以防止骨折愈合受损。它应该适用于90-120天。
结论：德国手外科医生达成共识，何时以及如何应用LIPUS改善手部骨折愈合。需要直接比较有和没有LIPUS的骨折治疗的随机对照试验，以客观数据支持这些陈述。
方法：基于德尔菲共识方法，关于LIPUS在手外科中使用的初步问题清单是由手外科和整形外科医生以及心理学家和传播学专家组成的跨学科团队开发的。基于这些,调查问卷被发明出来，总共进行了三次德尔菲轮。Delphi小组成员由11名德国手外科医师组成，他们的手外科经验平均为15年（7-23年）。在此过程中修改了问题和声明，在第三轮结束时达成共识。
结果：经过三轮Delphi，可以得出以下建议。LIPUS可用于手指骨折愈合受损，掌骨，腕骨以及预防性程序，以避免进一步的翻修手术。除了用于延迟愈合和不愈合的翻修手术外，LIPUS治疗也是有用的。在某些危险因素的情况下(再植，血运重建,骨质疏松,吸烟)，它可以在术后直接应用，以防止骨折愈合受损。它应该适用于90-120天。
结论：德国手外科医生达成共识，何时以及如何应用LIPUS改善手部骨折愈合。需要直接比较有和没有LIPUS的骨折治疗的随机对照试验，以客观数据支持这些陈述。
