Aims To evaluate whether low-intensity pulsed ultrasound (LIPUS) accelerates bone healing at osteotomy sites and promotes functional recovery after open-wedge high tibial osteotomy (OWHTO). Methods Overall, 90 patients who underwent OWHTO without bone grafting were enrolled in this nonrandomized retrospective study, and 45 patients treated with LIPUS were compared with 45 patients without LIPUS treatment in terms of bone healing and functional recovery postoperatively. Clinical evaluations, including the pain visual analogue scale (VAS) and Japanese Orthopaedic Association (JOA) score, were performed preoperatively as well as six weeks and three, six, and 12 months postoperatively. The progression rate of gap filling was evaluated using anteroposterior radiographs at six weeks and three, six, and 12 months postoperatively. Results The pain VAS and JOA scores significantly improved after OWHTO in both groups. Although the LIPUS group had better pain scores at six weeks and three months postoperatively, there were no significant differences in JOA score between the groups. The lateral hinge united at six weeks postoperatively in 34 (75.6%) knees in the control group and in 33 (73.3%) knees in the LIPUS group. The progression rates of gap filling in the LIPUS group were 8.0%, 15.0%, 27.2%, and 46.0% at six weeks and three, six, and 12 months postoperatively, respectively, whereas in the control group at the same time points they were 7.7%, 15.2%, 26.3%, and 44.0%, respectively. There were no significant differences in the progression rate of gap filling between the groups. Conclusion The present study demonstrated that LIPUS did not promote bone healing and functional recovery after OWHTO with a locking plate. The routine use of LIPUS after OWHTO was not recommended from the results of our study. Cite this article: Bone Jt Open 2022;3(11):885–893.

Purpose : To evaluate the clinical outcomes and effectiveness of the newly developed oblique locking hip screw (OLHS) compared with those of the commonly used cephalomedullary nail (CMN) in trochanteric femoral fracture treatment in older patients. Methods : This was single-center retrospective study of patients with trochanteric fractures. Overall, 129 patients were analyzed: 64 treated with OLHS and 65 with CMN. Patient demographic data, fracture classification, surgical parameters (e.g., operating time and intraoperative blood loss), and clinical outcomes were assessed. Postoperative outcomes were evaluated using radiographic findings and statistical analyses, including Fisher’s exact test and the Mann–Whitney U test. Results : The study included 57 patients in both the OLHS and CMN groups with 3 months of radiographic follow-up data. OLHS was more commonly used for stable AO A1 fractures, whereas CMN was preferred for unstable A2 fractures. The OLHS group showed slightly better outcomes in terms of reduced stability, with less frequent postoperative telescoping than the CMN group (4.8±4.3 mm for OLHS vs. 3.0±4.7 mm for CMN, p < 0.05). No significant differences in mortality, bone union rates, or adverse outcomes were observed between the two groups. However, two patients in the CMN group exhibited nonunion and one required conversion to total hip arthroplasty. Conclusion : OLHS provides satisfactory clinical outcomes comparable to those of CMN for trochanteric fractures, with potential advantages in terms of stability and lack of observable negative outcomes. OLHS may serve as a viable option for treating various types of trochanteric fractures, including unstable fractures.