title: [Detection of bone fragments in pulmonary vessels following extracorporeal shock wave application to the distal femur in an in-vivo animal model].
abstract: OBJECTIVE
  In urology, single cases of lethal pulmonary embolism following extracorporeal shock wave application to renal concrements have been reported. Therefore, lungs of rabbits were histopathologically investigated following extracorporeal shock wave application to the femur.
  
  
  METHODS
  In 8 mature Chinchilla-Bastard rabbits, shock wave application to one distal femur was performed with energy flux density of 0.9 mJ/mm2. In another 6 rabbits, sham-treatment (0 mJ/mm2) to one distal femur was performed. 6 weeks later, the animals were sacrificed and their lungs were blindly investigated by an independent pathologist.
  
  
  RESULTS
  In 7 out of the 8 treated animals (0.9 mJ/mm2) but in none of the sham-treated controls, patchy discolorations of the surface of the lung were observed. Furthermore, in 6 out of the 8 treated animals but in none of the sham-treated controls, bony fragments with signs of resorption were observed in lung vessels.
  
  
  CONCLUSIONS
  Application of extracorporeal shock waves with energy flux densities higher than 0.9 mJ/mm2 has been recommended in the literature for the treatment of aseptic non-unions. In this procedure, the possibility of the occurrence of bone fragments in the lung with the potential risk of pulmonary embolism should be regarded.
authors.affiliation: Orthopädische Klinik, Ludwig-Maximilians-Universität München, Klinikum Grosshadern, Munich. markus.maier@helios.med.uni-muenchen.de
authors.forename: M
authors.initials: M
authors.lastname: Maier
authors.forename: J A
authors.initials: JA
authors.lastname: Freed
authors.forename: S
authors.initials: S
authors.lastname: Milz
authors.forename: C
authors.initials: C
authors.lastname: Pellengahr
authors.forename: C
authors.initials: C
authors.lastname: Schmitz
mesh_terms: D000818:Animals; D005260:Female; D005269:Femur / Q000473:pathology*; D005548:Foreign-Body Migration / Q000473:pathology*; D019220:High-Energy Shock Waves / Q000009:adverse effects*; D008168:Lung / Q000473:pathology; D055370:Lung Injury; D011650:Pulmonary Alveoli / Q000473:pathology; D011655:Pulmonary Embolism / Q000473:pathology*; D011817:Rabbits
vernacular_title: Nachweis von Knochenfragmenten in Lungengefässen nach hochenergetischer Stosswellenapplikation am distalen Femur in einem In-vivo-Tiermodell.