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Extracorporeal shock wave treatment in nonunions of long bone fractures

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Abstract

We reviewed the clinical results of the past 7 years in order to investigate the effect of extracorporeal shock wave therapy (ESWT) in nonunions of long bone fracture. Sixty-nine patients with 69 nonunions (22 femora, 28 tibiae, 13 humeri, 5 radii, and 1 ulna) were treated with extracorporeal shock waves. The technical parameters were 6,000 to 10,000 impulses at 28 kV (0.62 mJ/mm2 energy flux density) for the femur and tibia, 4,000 impulses at 24 kV for the humerus (0.56 mJ/mm2 energy flux density), and 3,000 impulses at 24 kV (0.56 mJ/mm2 energy flux density) for the radius and ulna. Sixty-six patients were followed up. The total successful rate of bony union was 75.4%. ESWT was successful in hypertrophic nonunions and seemed to have no evident effect in atrophic nonunions. We believe that extracorporeal shock wave therapy may be a good choice for nonunions of long bone fracture especially in hypertrophic nonunions.

Résumé

L’objectif de cette étude a été d’évaluer cliniquement les résultats observés sur les 7 dernières années lde a technique extracorporelle “schock wave” (ESWT) sur le traitement des pseudarthroses des os longs. Matériel et méthode : 69 patients présentant 69 pseudarthroses (22 fémurs, 28 tibias, 13 humérus, 5 radius et 1 cubitus) ont été traités selon cette méthode. Les paramètres techniques étaient de 6000 et de 10000 impulsions à 28 kV (062 mJ/mm2) pour le fémur et le tibia, 4000 impulsions à 24 kV pour l’humérus (0.56 mJ/mm2), 3000 impulsions à 24 kV (0.56 mJ/mm2) pour le radius et le cubitus. Résultats : 66 patients ont été suivis pendant au moins 12 mois. Le taux de consolidation a été de 75,4%. La ESWT est une technique qui permet de traiter une pseudarthrose hypertrophique alors qu’elle a peu d’effet sur les pseudarthroses atrophique. Conclusion : nous pensons que cette technique est une technique de choix pour les pseudarthroses des os longs spécialement lorsque ces pseudarthroses sont hypertrophiques.

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Authors and Affiliations

  1. Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, People’s Republic of China

    Zhi-Hong Xu, Qing Jiang, Dong-Yang Chen, Jin Xiong, Dong-Quan Shi & Tao Yuan

  2. Department of Cell Biology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA

    Xiao-Lin Zhu

  3. The Center for Diagnosis and Treatment of Joint Disease, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People’s Republic of China

    Qing Jiang

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  1. Zhi-Hong Xu
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  2. Qing Jiang
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  4. Jin Xiong
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  7. Xiao-Lin Zhu
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Correspondence to Qing Jiang.

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Xu, ZH., Jiang, Q., Chen, DY. et al. Extracorporeal shock wave treatment in nonunions of long bone fractures. International Orthopaedics (SICOT) 33, 789–793 (2009). https://doi.org/10.1007/s00264-008-0553-8

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  • DOI: https://doi.org/10.1007/s00264-008-0553-8

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