Sebastian Hempe1, Dan Bieler2,3, Grit Braunegger4, Thomas Schilling1, Stephan Waldeck5, Erwin Kollig1. 1. Klinik für Unfallchirurgie und Orthopädie, Wiederherstellungschirurgie, Handchirurgie, Verbrennungsmedizin, Bundeswehrzentralkrankenhaus Koblenz, Rübenacher Str. 170, 56072, Koblenz, Deutschland. 2. Klinik für Unfallchirurgie und Orthopädie, Wiederherstellungschirurgie, Handchirurgie, Verbrennungsmedizin, Bundeswehrzentralkrankenhaus Koblenz, Rübenacher Str. 170, 56072, Koblenz, Deutschland. danbieler@uni-duesseldorf.de. 3. Klinik für Orthopädie und Unfallchirurgie, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland. danbieler@uni-duesseldorf.de. 4. Klinik für Nuklearmedizin, Bundeswehrzentralkrankenhaus Koblenz, Koblenz, Deutschland. 5. Klinik für Radiologie und Neuroradiologie, Bundeswehrzentralkrankenhaus Koblenz, Koblenz, Deutschland.
Abstract
BACKGROUND: Impaired posttraumatic bone healing is a relevant complication of fractures. Usually, the standard treatment is surgical revision. For about 30 years extracorporeal shockwave therapy (ESWT) has emerged as an alternative treatment option with similar consolidation rates but less complications. OBJECTIVE: This article aims to present our data in context to the current literature MATERIAL AND METHODS: From 2007 to 2016 a total of 97 patients diagnosed with impaired posttraumatic bone healing were treated with ESWT. Clinical and demographic data of this population were retrieved and analyzed retrospectively. RESULTS: The general consolidation rate was 60.8%. Multiple variables were analyzed. A preinterventional bone gap ≥ 5 mm, initial dislocation > ½ of the bone shaft, nicotine consumption and a long time span from fracture to ESWT (> 6 months) were found as factors which significantly impair bone healing after ESWT. CONCLUSION: ESWT is a safe and promising alternative treatment option for delayed unions. Regarding risk factors of a poor outcome may be identified before and increase the rate of success.
BACKGROUND: Impaired posttraumatic bone healing is a relevant complication of fractures. Usually, the standard treatment is surgical revision. For about 30 years extracorporeal shockwave therapy (ESWT) has emerged as an alternative treatment option with similar consolidation rates but less complications. OBJECTIVE: This article aims to present our data in context to the current literature MATERIAL AND METHODS: From 2007 to 2016 a total of 97 patients diagnosed with impaired posttraumatic bone healing were treated with ESWT. Clinical and demographic data of this population were retrieved and analyzed retrospectively. RESULTS: The general consolidation rate was 60.8%. Multiple variables were analyzed. A preinterventional bone gap ≥ 5 mm, initial dislocation > ½ of the bone shaft, nicotine consumption and a long time span from fracture to ESWT (> 6 months) were found as factors which significantly impair bone healing after ESWT. CONCLUSION: ESWT is a safe and promising alternative treatment option for delayed unions. Regarding risk factors of a poor outcome may be identified before and increase the rate of success.
Authors: Markus Rupp; Nike Walter; Christian Pfeifer; Siegmund Lang; Maximilian Kerschbaum; Werner Krutsch; Florian Baumann; Volker Alt Journal: Dtsch Arztebl Int Date: 2021-10-08 Impact factor: 8.251