http://www.healmybone.com/ http://www.healmybone.com/extra/news/74/Commissioning-NHS-Trust-Business-Case http://www.healmybone.com/extra/news/74/Commissioning-NHS-Trust-Business-Case An example business case can be seen in the images below. Bioventus are available to help with completion of a business case if needed. If you require our help please contact us via email submitting the following details: Name NHS Trust Contact Telephone number Contact email address Any additional comments Wed, 24 Apr 2013 00:00:00 GMT http://www.healmybone.com/extra/news/73/EXOGEN-Featured-on-BBC-Radio-Berkshire http://www.healmybone.com/extra/news/73/EXOGEN-Featured-on-BBC-Radio-Berkshire Listen to the feature below:  Fri, 22 Feb 2013 00:00:00 GMT http://www.healmybone.com/extra/video/21/EXOGEN-Featured-on-BBC-North-East http://www.healmybone.com/extra/video/21/EXOGEN-Featured-on-BBC-North-East Mon, 21 Jan 2013 00:00:00 GMT http://www.healmybone.com/extra/news/72/New-NICE-medical-technology-guidance-MT12-supports-the-case-for-adoption-of-EXOGEN http://www.healmybone.com/extra/news/72/New-NICE-medical-technology-guidance-MT12-supports-the-case-for-adoption-of-EXOGEN Media news releases:  EXOGEN NICE Guidance - News Release NICE Guidance Offers Hope to Thousands of Patients With Fractures That Won't Heal  - Ultrasound device could save NHS millions by avioding surgery Download news release here EXOGEN NICE Guidance MTG12 - Healthcare Professionals NICE Guidance Supports use of EXOGEN for Long Bone Fractures with Non-Union   Download news release here Above: EXOGEN device Download larger version The new NICE guidance, what does it mean for you? Patients click here Healthcare Professional click here  Wed, 9 Jan 2013 00:00:00 GMT http://www.healmybone.com/extra/news/68/Making-the-Case-for-Case-Management http://www.healmybone.com/extra/news/68/Making-the-Case-for-Case-Management Heal My Bone (HMB): Case management isn’t something many people have heard about. Is it a new idea? Liz Haunch (LH): “Case management first evolved after the Second World War to help soldiers who were suffering from complex injuries that required different types of hospital and outpatient care. Today their role is to make a significant impact on the speed and success of a patients’ rehabilitation.” HMB: So why is it needed in today’s modern NHS? LH: “Looking at the treatment side of things, in a perfect world we wouldn’t exist. There would be complete co-ordination by the NHS of the all the care that a patient needs. “ “For a patient with a non-union fracture, there will certainly be orthopaedic care but also possibly plastic surgery, as well as the post-operative areas of fracture clinics, physiotherapy or occupational therapy.  It’s not always easy to keep it all on track when appointments can be months apart and on different sites.” HMB: Who approaches you to get involved, the patient? LH: “Case managers are brought in by legal firms and insurance companies after an accident has taken place and another party is considered liable for causing it. “Our job is to assist the patient by looking in detail at their individual needs and help them to avoid feeling pushed around, or lost, in what can be a bewildering set of circumstances.” The majority of case management is dealing with the medical needs of the patient and case managers doing this sort of work should have a health care qualification or relevant professional background. This experience enables us to see things from the patient’s point of view. You might say that we are the bridge between the patient’s complex and unique set of needs and a third party company who sees things in terms of a process to be followed.” HMB: OK, so you’ve been asked to get involved, what happens next? LH: “We begin by visiting the patient in their homes to understand what kind of problems they face each day. A tricky set of stairs to climb or a steep driveway is something that can only really be appreciated with your own eyes but might be the single biggest hurdle to a patient being able to live normally in their own home.” “We then prepare a detailed report that is sent simultaneously to the patient, their legal representatives and the insurance company that has employed us. With everyone getting the report at the same time, it’s a fair place to start to discuss and agree a way forward. The ultimate goal for everyone concerned is to achieve a successful treatment outcome for the patient and to get them living a normal life and ideally back to work.” “The question of whether a patient is really able to return to work properly is a fine judgment to make. Many patients are either keen to get back to a normal routine or in fear of losing their job that there is a great deal of pressure, both real and imaginary, to return to work when it might be too soon.” HMB: So you are you are representing the patient but are paid by the insurance company; that must be delicate sometimes. LH: “In addition to managing interactions with legal and insurance companies, at the centre of a case manager’s duties is the patient with an injury, and from our personal point of view, the patient should always be seen as the most important party. “We aim to get the right balance for each individual patient; between helping them become self-reliant in their own home and ensuring that any entitlements to help them do that are delivered properly.” HMB: You must have seen more than your fair share of fractures LH: “It’s rare for our patients not to have fractures as part of their catalogue of injuries, but it’s certainly true that a lot of patients need case manager support because despite the best treatment, their bones have failed to heal and the impact on their life of a non-union fracture can be considerable and long lasting.  Non-unions are incredibly frustrating for patients and, in many cases, lead to months of waiting and anguish about the lack of treatment options, not to mention the prospect of additional surgery. Reducing that waiting time is an incredibly important job. HMB: How did you hear about the EXOGENUltrasound Bone Healing System? LH: “An orthopaedic surgeon had recommended it for a patient I was working with. It sounded interesting so I set about finding out more. HMB: Since then you’ve encouraged the use of EXOGEN for a number of patients  as part of their treatment. What’s the appeal? LH: Nobody involved in the kind of cases we deal with wants healing to take any longer than it possibly needs to.We looked carefully at the clinical research which examined whether fractures heal sooner using EXOGEN, without the need for further surgery3. The data says 86% of non-unions treated with EXOGEN healed, and this has matched our experience so far, as our patients with non-unions have had good results and made progress to full healing.” HMB: When you suggest an EXOGEN to the insurance company, how do they react? LH: “Insurers see that there is a strong body of evidence to show that healing takes place in a very high proportion of cases, the 86% I mentioned before and the cost of the EXOGEN device compared to months, or even years, stretching ahead where the patient has not healed and needs care and financial support is a straightforward decision.” HMB: How do patients feel about using EXOGEN? LH: “We get tremendous satisfaction from working with patients as they turn a corner in their recovery and the fact that EXOGEN enables patients to have an active role in their treatment. --A lot of patients tell us the daily use of the device for 20 minutes helps them feel that they are contributing to their treatment.. “EXOGEN has quickly become one of our first considerationswhen we meet a patient with a non-union fracture and in our experience insurers are generally very happy to approve it.” HMB: Tell us a little bit about the Case Management Society UK LH: “I am a director of the Case Management Society UK. CMSUK supports professional practice in this growing sector and provides development services to its 430 members across the UK. Further information on the work of case managers is available from the Society’s website www.cmsuk.org.” Thu, 17 May 2012 00:00:00 GMT http://www.healmybone.com/extra/news/70/Skier-and-Snowboarder-Magazine-publishes-EXOGEN-spread http://www.healmybone.com/extra/news/70/Skier-and-Snowboarder-Magazine-publishes-EXOGEN-spread Read Pauline's full story here: http://www.healmybone.com/patient-stories/casestudy/26/Physician-Heal-Thyself.-Four-Years-to-Recovery-for-an-Experienced-BikerRead Dave's full story here: http://www.healmybone.com/patient-stories/casestudy/3/How-EXOGEN-helped-Dave-Crowthers-non-union-to-heal-after-an-Alpine-fallWatch Dave's video story below. Thu, 19 Apr 2012 00:00:00 GMT http://www.healmybone.com/extra/news/65/Suggested-tips-for-life-in-a-cast http://www.healmybone.com/extra/news/65/Suggested-tips-for-life-in-a-cast Caring for your Cast Try to keep your cast dry. A wet cast may need to be replaced, which could become an inconvenience. Casts are designed to keep fractures stable, immobile and supported as much as possible. Your doctor may opt to wait a while to fit a permanent cast due to swelling, surgery or peripheral bone or skin trauma. Remeber, always try to follow your doctor’s instructions. If you initially experience swelling after having a cast fitted: Immediately contact your doctor for advice; and Keep your cast elevated, if possible Even though some synthetic casts are moisture resistant it is a good idea to try and keep your cast dry, because the padding is not water resistant.  Trimming or removing the cast’s padding probably isn’t a good idea as this may damage it. If it needs corrective attention contact your doctor. Caring for yourself Consult your doctor immediately if you experience any of the following: Increased pain or swelling Numbness or tingling at or near the injury site Bleeding or drainage from the cast Painful rubbing Fever or chills Damage to the cast (including wetness), or if it feels too loose / too tigh Any major changes to your health Essential cast information Casts come in many shapes and sizes, but the two most common types are made from plaster and fiberglass. Your doctor will select the type of cast that best treats and protects your fracture. For less severe injuries, sometimes a splint (a removable cast) may be custom made from one of these materials. Plaster casts are padded with thick cotton and wrapped in elastic bandages to make them more comfortable. Fiberglass casts are usually fitted when the swelling has subsided. These are lighter, longer wearing, and more breathable than their plaster counterparts. They are also more robust and require less maintenance. Often after breaking a bone you may be placed in a plaster cast for a few days or a week. You may then be placed in the fiberglass cast. This may vary and some patients will keep their plaster cast on for the duration of the healing process. A fiberglass cast may be changed every three to six weeks. Wearing a cast may cause unexpected difficulties in your everyday activities. For example casts on the arm or hand may complicate gripping, reaching, dressing, writing and eating. Leg casts may make it difficult to dress, reach, walk and drive. Look out for other tips on www.healmybone.com about how to live more successfully with your fracture.Take a look at our tips section. *Disclaimer: You should always consult with your treating physician. Fri, 3 Feb 2012 00:00:00 GMT http://www.healmybone.com/extra/news/63/Avoiding-fractures-in-cold-weather-conditions http://www.healmybone.com/extra/news/63/Avoiding-fractures-in-cold-weather-conditions Keeping warm It is essential to keep warm and to follow as healthy a lifestyle as possible - for instance: A balanced diet will help keep you warm and healthy in the winter Wearing the right kind of clothes / footwear may keep you warmer and help avoid falls Ensure your house is sufficiently heated to keep you warm. The UK Department of Health has issued a guide ‘Keep Warm – Keep Well’ which offers advice on how to keep warm. It also includes details on a number of key organisations offering practical advice. Slippery Surfaces It's important to recognise the danger of slippery surfaces. Here are some tips that may help reduce the risk of falling when slippery conditions exist: Wear boots or overshoes with a good grip on the soles. Avoid walking in shoes that have smooth surfaces, which may increase the risk of slipping. Walk carefully. Be alert to the possibility that you could quickly slip on an unseen patch of ice. Avoid the temptation to run to catch a bus or beat traffic when crossing a street. Walk cautiously. Your arms help keep you balanced, so keep hands out of pockets and avoid carrying heavy loads that may cause you to become off balance. Walk "small and slow." Avoid big / quick steps. Look to see ahead of where you step. When you step on icy areas, take short, shuffling steps, curl your toes under and walk as flatfooted as possible. Remove snow immediately before it becomes packed or turns to ice. Keep your garden path and driveway free of ice by frequently clearing snow and applying salt or grit. This may help prevent formation of dangerous ice patches. If you do fall seek medical assistance from the emergency services immediately. For more news, hints and tips on fractures visit www.healmybone.com,  connect with us on Facebook or follow us on Twitter! Wed, 1 Feb 2012 00:00:00 GMT http://www.healmybone.com/extra/video/19/Fracture-Healing-How-EXOGEN-may-speed-up-bone-healing-2012-updated-Mechanism-of-Action http://www.healmybone.com/extra/video/19/Fracture-Healing-How-EXOGEN-may-speed-up-bone-healing-2012-updated-Mechanism-of-Action Thu, 26 Jan 2012 00:00:00 GMT http://www.healmybone.com/extra/news/59/Hi-tech-gadget-that-keeps-me-going-for-gold-Daily-Mail http://www.healmybone.com/extra/news/59/Hi-tech-gadget-that-keeps-me-going-for-gold-Daily-Mail The following article appeared in the Daily Mail on December 28th 2011:It is a condition that has blighted the careers of some of the star names in sport. And now it’s threatening the dreams of Scots international footballer Jonny Paterson.The talented 23-year-old from Motherwell, Lanarkshire, who captained Team GB at the Beijing Paralympics in 2008, broke a metatarsal bone in his foot during training last September. Suddenly, his hopes of making the London Games next yearlooked bleak. But now his chances have been boosted by a revolutionary new machine that has helped other professional athletes regain peak fitness after suffering the same crippling injury.His hopes rest on EXOGEN, a device about the size of a mobile phone that uses low-intensity ultrasound shockwaves to treatthe injured bone.Yesterday Mr Paterson was sure the non-invasive painless treatment was working. He said: ‘My last X-ray showed some improvement, which is great. So I’m hoping to return to the squad and make it to the Team GB training camp in San Diego next month.’Mr Paterson explained the break in his foot was in part due to the constant stress he has placed on his bones during his playing career.He now uses the machine for 20 minutes a day. Normally, patients with stubborn bone fractures face surgery, followed by months of rehabilitation but the EXOGEN device can speed up a recovery by 38 per cent.Mr Paterson, who helps to coach an under-11s team, has right-sided cerebral palsy which leaves him with difficulty building strength in the right side of his body. But he has excelled at football since joining the international squad almost seven years ago. He said: ‘I’ve always liked to be involved. That’s been the hardest bit – being stuck on the bench and having to sit on the sidelines.’ He was given the use of the machine by its maker, Smith & Nephew, who made it available through the charity Dream It Believe It Achieve It, set up by other Paralympians. The machine has been used worldwide since 1997 and is used by about 70,000 patients each year.Mr Paterson added: ‘After San Diego, we’ll play two friendlies against America. Then we have the Paralympic World Cup in May as a run-up to the London games. ‘Scotland have done well in the past few championships and we have finished ahead of England in the last three or four events. ‘I will have to fight for my place as captain in the Olympics but I’m hopeful and confident.’By Julie-Anne Barnes Tue, 3 Jan 2012 00:00:00 GMT http://www.healmybone.com/extra/video/13/Glasgow-surgeon-using-EXOGEN-for-fracture-healing-Feature-on-BBC-television http://www.healmybone.com/extra/video/13/Glasgow-surgeon-using-EXOGEN-for-fracture-healing-Feature-on-BBC-television Exogen has been featured on the BBC.  Orthopaedic surgeon Angus MacLean and fracture patient Gary Denham have talked about their experience of the treatment.Read the full story on the BBC's website...* The video is reproduced with kind permission by BBC Scotland. Tue, 25 Oct 2011 00:00:00 GMT http://www.healmybone.com/extra/news/47/Exogen-featured-in-Daily-Express-and-Mail-on-Sunday http://www.healmybone.com/extra/news/47/Exogen-featured-in-Daily-Express-and-Mail-on-Sunday Mail on Sunday: Shockwaves that can heal broken bones: New treatment avoids need for surgery on fractures that won't join upDaily Express: Woman regains use of hands with sign language and self healing Fri, 1 Jul 2011 00:00:00 GMT http://www.healmybone.com/extra/news/46/Ultrasound-boosts-fracture-healing-NHS-Choices http://www.healmybone.com/extra/news/46/Ultrasound-boosts-fracture-healing-NHS-Choices Read the story on the NHS Choices website... The trial gave 101 slow-healing patients either a genuine LIPUS treatment or an inactive sham treatment over 16 weeks. The LIPUS device was found to increase bone mineral density by 34% more than the sham device, and 65% of the LIPUS-treatment group were considered by a doctor to be healed compared to 46% of the sham-treatment participants. While there was a drop-out rate of around 10%, the use of the device looks promising as it is a non-invasive treatment and no side effects were reported. Overall, this preliminary trial suggests that the treatment may be of some benefit to patients with delayed fracture healing.   Where did the story come from? The study was carried out by researchers from University Hospital Marburg and the University of Ulm in Germany. It was funded by Smith and Nephew, the manufacturers of the device used in this study. The study was published in the peer-reviewed medical journal BMC Musculoskeletal Disorders. The research was well reported by The Daily Telegraph.   What kind of research was this? This was a randomised controlled trial that assessed whether low-intensity pulsed ultra sound (LIPUS) would increase bone healing compared with a sham treatment. The researchers were interested in whether the treatment would help people who had shown a slow rate of healing four months after their injury. The researchers say that LIPUS has been shown to enhance healing in fresh fractures, and that some non-controlled trials suggest that LIPUS may help promote healing in older fractures that have failed to heal. However, they said no randomised controlled trial has been carried out among patients who had delayed fracture healing. The manufacturers of the device suggest that the LIPUS device can perform several different roles in bone healing. They say that immediately after a break it can remove debris and bacteria from the site of the wound, while in later healing stages it can stimulate the bone marrow to produce immature bone cells and cartilage cells. The manufacturers say that during latter-stage healing (the period examine in this study), the device stimulates the membrane around the bone to seal. This allowed immature bone cells to collect and grow.   What did the research involve? The research was carried out in six hospitals in Germany. The study recruited adults who had a fracture to their tibia (shin bone) but had displayed inadequate healing at least 16 weeks after their injury. The study did not include patients who were pregnant, had infected wounds, had excessive malalignment of their bone following the fracture, or had received an operation at the fracture site within 16 weeks of enrolment. In total, 101 subjects between 14 and 70 years old were recruited and randomly allocated to treatment with either the active LIPUS device (51 people) or an inactive ‘sham’ LIPUS device (50 people). The device was the Exogen 2000/2000+, which is manufactured by Smith and Nephew in Germany. The participants were instructed to use the device for 20 minutes a day for 16 weeks. All of the devices recorded the usage time per day as a means of assessing whether the participants were complying with the study protocol. Computed tomography (CT) scanning was used to assess bone mineral density (BMD) and the gap at the fracture site. BMD was assessed at three regions of interest: the fracture site, 2-3 mm either side of the fracture site, and a healthy reference area. These measurements were taken before treatment and after the 16-week treatment course. Radiographs were also taken at one, two and three months. These were shown to doctors who judged the healing status (healed/not healed) of each subject.   What were the basic results? Out of 101 participants who started the study, 84 completed it. Twelve out of the 50 participants who received sham treatment dropped out (24%), and five out of 51 of the LIPUS treated patients dropped out (9.8%). Overall, compliance with the treatment regimen was good. The median total time of device usage was 2,040 minutes out of a possible 2,240 minutes (91%). In their statistical analysis the researchers took into account the potential bias of patients who had dropped out. The improvement in BMD was 1.34 (90% CI, 1.14 to 1.57) times greater for LIPUS-treated participants compared with the sham controls (p=0.002). The LIPUS-treated participants also had a greater reduction in the gap between their bone at the fracture site compared to the controls over the 16-week period (p=0.014). At completion of the 16-week treatment period, 65% of LIPUS and 46% of sham-treated participants were considered by a doctor to be healed (p=0.07). The LIPUS device did not cause any side effects.   How did the researchers interpret the results? The researchers said that under normal clinical circumstances, approximately 4.4% of patients with shin bone fractures will have delays in bone healing. Surgery and bone grafts may be necessary in these patients. The researchers said that their research has extended the positive findings that LIPUS treatment can help healing in fresh fractures by showing that it benefits patients whose fractures have taken longer to heal.   Conclusion This was a well-conducted randomised controlled trial, which showed that use of LIPUS improved the healing process by 34% compared to a control treatment. As the device was used by the patients at home, a good aspect of the study design was that it recorded the amount of time patients used the device to assess whether they followed the study protocol. However, compliance with the device and adherence to the treatment instructions may be different when used by patients outside of the study setting. Also, 16% of the participants dropped out of the study, and their reasons for dropping out were not presented. As more patients had dropped out of the sham control group than the LIPUS group, the researchers used statistical modelling to adjust for potential bias this may have caused to their results. However, details of how this was done were not explicit. Overall, this preliminary study suggests that this non-invasive treatment appears to be of some benefit to patients who have delayed fracture healing. Mon, 13 Jun 2011 00:00:00 GMT http://www.healmybone.com/extra/news/45/Ultrasound-device-helps-bones-heal-faster-and-stronger-Daily-Telegrpah http://www.healmybone.com/extra/news/45/Ultrasound-device-helps-bones-heal-faster-and-stronger-Daily-Telegrpah The article below by Richard Alleyne, Science Correspondent, appeared in the Daily Telegraph, 08 Oct 2010. Read the article here. Researchers tested the therapy on patients with fractured shin bones, or tibias, which had not properly healed after more than four months. Half the 100 participants were treated with an ultrasound probe and half with a "sham" device. Over a period of 16 weeks, faster healing in patients receiving the "real" treatment resulted in 34 per cent greater bone density at the injury site. The treatment, called LIPUS, (low-intensity pulsed ultrasound) is delivered by a small emitter linked to a handheld controller. Therapy sessions lasting 20 minutes were conducted every day throughout the study period. The research was conducted by a team of German scientists backed by global medical devices manufacturer Smith and Nephew. Dr Jon Block, a US consultant for the company based in San Francisco, said: "These findings demonstrate significantly greater progress toward bone healing after LIPUS treatment compared to no LIPUS treatment in subjects with established delayed unions of the tibia. "This should assist in establishing this non-invasive modality as a viable, effective treatment option for patients suffering these injuries." The trial results were reported today in the online journal BMC Musculoskeletal Disorders. The patients taking part in the study had a wide age range from 14 to 70. All had fractures of the shin bone shaft that had failed to heal adequately after a significant amount of time. Delayed "union" - the knitting together of broken bones - occurs in around 4.4% of tibial fractures. Sometimes the bones do not mend at all, resulting in functional impairment and loss of quality of life. Currently "non-unions" are tackled with complex and costly procedures which involve grafting on extra pieces of bone and the use of growth-promoting chemicals. Ultrasound has been shown to accelerate fracture healing by boosting the activity of osteoblasts, the cells that synthesise bone. Mon, 13 Jun 2011 00:00:00 GMT http://www.healmybone.com/extra/news/43/Technology-reviewed-in-new-NICE-guidelines http://www.healmybone.com/extra/news/43/Technology-reviewed-in-new-NICE-guidelines The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Low intensity pulsed ultrasound to promote fracture healing.To read the full NICE article click here. Thu, 2 Jun 2011 00:00:00 GMT http://www.healmybone.com/extra/news/44/David-Ball-uses-EXOGEN-to-speed-recovery http://www.healmybone.com/extra/news/44/David-Ball-uses-EXOGEN-to-speed-recovery Manchester City FC's young striker David Ball uses EXOGEN ti aid his fracture recovery. Click here to view his video diary, tracking his recovery. Thu, 2 Jun 2011 00:00:00 GMT http://www.healmybone.com/extra/news/49/David-Nugent-I-recovered-in-record-time http://www.healmybone.com/extra/news/49/David-Nugent-I-recovered-in-record-time Read the full story... Thu, 5 May 2011 00:00:00 GMT