Shock wave therapy of fracture nonunion

Injury
Hazem M I Alkhawashki

Abstract

We have used the principles of extracorporeal shock wave therapy (ESWT) in the treatment of nonunion of fractures in 44 patients (49 bones).There were 35 males and 9 females with a mean age of 34 years(range14-70). Clinical and radiological assessment was performed at regular time intervals with a minimum follow up of 18 months. Most common sites involved were the femur and tibia. The average time from initial fracture treatment to intervention with ESWT was 11.9 months (6 months to 5 years). Thirty eight non-union sites had one session of treatment and the rest (11) had more than one session. Union was successful in 75.5% of cases at a mean time of 10.2 months (range 3-19). Failure in the remaining cases was due to more than 5mm gap, instability, compromised vascularity (type of bone) and deep low grade infection; which was discovered at the time of surgical intervention when no signs of radiological healing occurred after 6 months from treatment. Failing sites were shaft of femur, scaphoid, neck of humerus and neck of femur. No local complications were observed.

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Citations

Jan 10, 2016·Injury·Peter V GiannoudisNikolaos K Kanakaris
May 26, 2017·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Marianne K E KoolenOlav P van der Jagt
Dec 21, 2018·Journal of Orthopaedic Trauma·Annika WillemsDuncan E Meuffels
Feb 10, 2020·Archives of Orthopaedic and Trauma Surgery·Jens EverdingMichael Raschke
Dec 18, 2018·OTA International : the Open Access Journal of Orthopaedic Trauma·Frederico C VallimDanielle C Bonfim
May 25, 2021·Archives of Physical Medicine and Rehabilitation·Yu-Pin ChenOscar Kuang-Sheng Lee
Aug 7, 2021·Nature Reviews. Disease Primers·Britt WildemannJesse B Jupiter
Sep 14, 2021·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Falko DahmRainer Mittermayr

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