Please click here to view the full Exogen Ultrasound Bone Healing Commissioning Statement.

Commissioning Position

This commissioning policy is needed to provide a commissioning position for the use of Exogen.

The use of the Exogen® system to treat long bone fractures with delayed union or any other indications is NOT commissioned.

(NB: NHS Vale of York CCG does NOT routinely commission an elective intervention on patients who have a BMI of 30 or above (classified as obese) or patients who are recorded as a current smoker – see commissioning statement 01. Optimising Outcomes from All Elective Surgery**)

NHS Vale of York Clinical Commissioning Group will fund the use of the Exogen® system to treat long bone fractures with non-union, in accordance with defined clinical criteria as follows:

• Patient age > 18 years
• Non-union of fracture > 9 months
• Not to be used in cases of unstable surgical fixation, not well aligned or where inter-fragment gap is > 10mm
• Not to be used in cases with infection
• Not to be used in pregnancy, patients with pacemakers or vertebral/skull fractures
• Only when lifestyle factors addressed**

**Note: patients with lifestyle factors which are known to delay fracture healing rates e.g. smoking and excess alcohol intake (i.e. men and women should not drink more than 14 units of alcohol each week¹), will be appropriately counselled and required to eliminate these risks before determining non-union status and ultimately eligibility for Exogen®. Where appropriate, referrals to specific support services should be arranged e.g. smoking cessation service.

NHS Vale of York Clinical Commissioning Group will NOT fund the use of the Exogen® system to treat long bone fractures with delayed union or any other indications for use of Exogen®.

These criteria will be reviewed on publication of new evidence in the form of relevant trial data, updated national guidance, or national or local audit outcomes.

Any identified new indications for use of the Exogen® system requiring additional funding will only be considered in exceptional circumstances through the Individual Funding Request Panel.

To submit an application to the CCG's Individual Funding Request Panel, please click here for further information.

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