title: Extracorporeal shockwave therapy (ESWT)--First choice treatment of fracture non-unions?
abstract: Fracture non-unions are still a challenging problem in orthopedics. The treatment of non-unions remains highly individualized, complex, and demanding. In most countries the surgical approach with debridement of the non-union gap, anatomical reduction and appropriate osteosynthesis along with autologous bone grafting is considered as the standard of care. One of the very first non-urologic applications of extracorporeal shockwave treatment (ESWT) concerned non-healing fractures. Since the early 1990ties the knowledge of the working mechanism has increased enormously. The purpose of this review article is to demonstrate by peer-reviewed literature in conjunction with our own experiences that ESWT can be an efficient, non-invasive, almost complication-free and cost effective alternative to surgical treatment of non-healing fractures.
authors.affiliation: AUVA Trauma Center Meidling, Vienna, Austria; Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Center, Austrian Cluster for Tissue Regeneration, Vienna, Austria.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Schaden
authors.affiliation: AUVA Trauma Center Meidling, Vienna, Austria; Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Center, Austrian Cluster for Tissue Regeneration, Vienna, Austria. Electronic address: Rainer.Mittermayr@trauma.lbg.ac.at.
authors.forename: Rainer
authors.initials: R
authors.lastname: Mittermayr
authors.affiliation: Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Center, Austrian Cluster for Tissue Regeneration, Vienna, Austria.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Haffner
authors.affiliation: Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Center, Austrian Cluster for Tissue Regeneration, Vienna, Austria.
authors.forename: Daniel
authors.initials: D
authors.lastname: Smolen
authors.affiliation: Department of Orthopedic Surgery and Traumatology, University Schleswig Holstein, Germany.
authors.forename: Ludger
authors.initials: L
authors.lastname: Gerdesmeyer
authors.affiliation: Center for Shockwave Medicine and Tissue Engineering, Department of Orthopedic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Ching-Jen
authors.initials: CJ
authors.lastname: Wang
mesh_terms: D017102:Fracture Healing; D005599:Fractures, Ununited / Q000628:therapy*; D019220:High-Energy Shock Waves / Q000627:therapeutic use*; D006801:Humans
keywords: ESWT; Extracorporeal shockwave therapy; Non-healing fractures; Non-union; Pseudarthroses