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High-energy extracorporeal shockwave therapy in humeral delayed and non-unions.

Authors :
Dahm F
Feichtinger X
Vallant SM
Haffner N
Schaden W
Fialka C
Mittermayr R
Source :
European journal of trauma and emergency surgery : official publication of the European Trauma Society [Eur J Trauma Emerg Surg] 2022 Aug; Vol. 48 (4), pp. 3043-3049. Date of Electronic Publication: 2021 Sep 13.
Publication Year :
2022

Abstract

Introduction: Within the last few decades, focused high-energy extracorporeal shockwave therapy (ESWT) has proven to be an effective alternative to standard of care revision surgery in delayed healing fractures or manifest non-unions in various anatomical regions.<br />Materials and Methods: A retrospective multi-variant analysis of an open prospective, single-armed clinical study was conducted. Patients receiving focused high-energy ESWT for a delayed healing or an apparent non-union of a humeral fracture between January 1999 and December 2015 at a single trauma center were included in the study. Bony healing was defined as cortical continuity in three of four cortices and pain-free force loading and evaluated using CT scans and clinical examination at three- and six-month follow-ups after ESWT.<br />Results: A total of 236 patients were included. N = 93 (43.8%) showed bony consolidation three months after ESWT and n = 105 (52.5%) after six months. Sub-group analysis showed significantly better healing for the proximal metaphyseal humerus (66.7% after six months, n = 42) compared to the diaphyseal region (48.1%, n = 133) and distal metaphyseal humerus (48.1%, n = 25). Regression analysis indicated significantly increased healing rates for patients of younger ages (p = 0.001) and a fracture diastasis of less than 5 mm (p = 0.002).<br />Conclusion: The findings of this study indicate that ESWT can be considered as a treatment option for a well-selected patient population despite the lower healing rates compared to other anatomical regions.<br /> (© 2021. Springer-Verlag GmbH Germany, part of Springer Nature.)

Details

Language :
English
ISSN :
1863-9941
Volume :
48
Issue :
4
Database :
MEDLINE
Journal :
European journal of trauma and emergency surgery : official publication of the European Trauma Society
Publication Type :
Academic Journal
Accession number :
34515810
Full Text :
https://doi.org/10.1007/s00068-021-01782-1