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

Autor: Dahm F; AUVA Trauma Center Meidling, Kundratstr. 37, 1120, Vienna, Austria. f.dahm@gmx.net.; Women's College Hospital, University of Toronto Orthopaedics Sports Medicine, Toronto, Canada. f.dahm@gmx.net., Feichtinger X; AUVA Trauma Center Meidling, Kundratstr. 37, 1120, Vienna, Austria.; Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Vienna, Austria., Vallant SM; AUVA Trauma Center Meidling, Kundratstr. 37, 1120, Vienna, Austria., Haffner N; Department for Orthopedics and Trauma Surgery, Krankenhaus Nord-Klinik Floridsdorf, Vienna, Austria., Schaden W; AUVA Trauma Center Meidling, Kundratstr. 37, 1120, Vienna, Austria.; Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Vienna, Austria.; Austrian Cluster for Tissue Regeneration, Vienna, Austria., Fialka C; AUVA Trauma Center Meidling, Kundratstr. 37, 1120, Vienna, Austria.; Medical Faculty, Sigmund Freud University, Vienna, Austria., Mittermayr R; AUVA Trauma Center Meidling, Kundratstr. 37, 1120, Vienna, Austria.; Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Vienna, Austria.; Austrian Cluster for Tissue Regeneration, Vienna, Austria.
Jazyk: angličtina
Zdroj: 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.
DOI: 10.1007/s00068-021-01782-1
Abstrakt: 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.
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.
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).
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.
(© 2021. Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
Externí odkaz: