title: [Extracorporeal shock wave therapy for delayed union of long bone fractures - preliminary results of a prospective cohort study].
abstract: Extracorporal shock wave therapy (ESWT) has been postulated as an additional therapeutic option in nonunion after fracture treatment. We have reexamined patients with nonunions treated at our institution to evaluate the efficacy of the method. In a prospective nonrandomized study patients were investigated with a minimum duration of nonunion of 6 months. Following 2 cycles of ESWT with 2000 impulses/18 kV, the reevaluation was performed at 1, 3 and 6 months after treatment. A total of 27 pseudarthroses was reevaluated, in 11 one or more reosteosyntheses had been performed prior to ESWT. Following ESWT we found a success rate of 41 % (n = 11). The clinical evidence of subjective, clinical improvement was found in 5 of these patients within 1 month, in all of these patients within a period of 3 months. Radiologic evidence of improvement occurred in none of these patients within 1 month, in all of these patients within 6 months. ESWT appears to represent an additional treatment option in patients with longstanding nonunion. If no improvement occurs, the maximum delay of reosteosynthesis is three months.
authors.affiliation: Unfallchirurgische Klinik, Medizinische Hochschule Hannover.
authors.forename: S
authors.initials: S
authors.lastname: Beutler
authors.forename: G
authors.initials: G
authors.lastname: Regel
authors.forename: H C
authors.initials: HC
authors.lastname: Pape
authors.forename: S
authors.initials: S
authors.lastname: Machtens
authors.forename: A M
authors.initials: AM
authors.lastname: Weinberg
authors.forename: I
authors.initials: I
authors.lastname: Kremeike
authors.forename: U
authors.initials: U
authors.lastname: Jonas
authors.forename: H
authors.initials: H
authors.lastname: Tscherne
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000628:therapy; D005500:Follow-Up Studies; D017102:Fracture Healing / Q000502:physiology*; D005597:Fractures, Open / Q000000981:diagnostic imaging / Q000628:therapy; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011542:Pseudarthrosis / Q000000981:diagnostic imaging / Q000628:therapy*; D011859:Radiography; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000628:therapy; D016896:Treatment Outcome