Treatment of non comminuted fracture by Low Laser Therapy.
Fracture of the calcaneum tongue type with comminution is commonly treated by orthopedic surgeons with operative intervention with plate and screws as well as frequently require harvest of bone graft from the patient’s pelvic bone. However, many patients nowadays refuse operative intervention as they dislike the idea of surgical scars both at the heel as well as the pelvis. To add to this, albeit operative fixation of comminuted tongue-type fractured calcaneum, orthopedic surgeons frequently advise non-weight bear walking for 12 week

The use of low-level laser therapy in promoting fracture healing of human fractures had previously been reported by the author and also from clinicians. The study represents the first ever study to assess the clinical use of LLLT in enhancing the re-modeling of comminuted tongue-type calcaneum fracture so as to allow early weight bearing without bone grafting, as well as prevention of widening of the breath .

The patient cohort consisted of 7 consecutive unselected patients with tongue type calcaneum fracture all with significant degree of comminution. All the patients refused operation and prefer early fracture healing and ambulation with non-operative means.
All patients on serial X-ray as well as CT scan checking not only had solid union of the significantly comminuted fracture, but all had good re-modelling of the buckling and increased width of the calcaneum bone. The calculated p value is statistically significant at p < 0.01

In conclusion the current prospective study of a clinical case series of patients presenting with communited tongue-type os calcis fracture revealed that low-level laser therapy if administered correctly can, on the one hand, augment the bone healing process without recourse to bone-grafting; and on the other hand re-model the fracture so that for the very first time in clinical medicine, correction of fracture communition can be achieved without the use of operative intervention. All patients tolerated very well this non-invasive form of conservative management at an affordable cost comparable to conventional physical therapy

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