Addition of shock wave therapy to nail dynamization increases the chance of long-bone non-union healing

Autor: Josef Stolberg-Stolberg, Thomas Fuchs, Moritz F. Lodde, Steffen Roßlenbroich, Patric Garcia, Michael Raschke, Jens Everding
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Journal of Orthopaedics and Traumatology, Vol 23, Iss 1, Pp 1-10 (2022)
Druh dokumentu: article
ISSN: 1590-9921
1590-9999
DOI: 10.1186/s10195-021-00620-9
Popis: Abstract Background Long-bone non-unions after intramedullary nailing can be treated by nail dynamization or focused high-energy extracorporal shock wave therapy (fESWT). The objective of this study was to assess the effect of the combination therapy of nail dynamization and fESWT on long-bone non-unions. Materials and methods 49 patients with long-bone non-unions (femur and tibia) after nailing were treated with nail dynamization (group D, n = 15), fESWT (group S, n = 17) or nail dynamization in addition to fESWT (group DS, n = 17). Patients were followed up for 6 months retrospectively. Furthermore, age, sex, Non-Union Scoring System (NUSS) score, time intervals from primary and last surgery until intervention and smoking status were analysed for their correlations to bone union. Results Union rates were 60% for group D, 64.7% for group S and 88.2% for group DS, with a significant difference between group D and DS (p = 0.024). Successful treatment was correlated with high age (OR 1.131; 95% CI 1.009–1.268; p = 0.034), female gender (OR 0.009; 95% CI 0.000–0.89; p = 0.039), low NUSS score (OR 0.839; 95% CI 0.717–0.081; p = 0.028) and negative smoking status (OR 86.018; 95% CI 3.051–2425.038; p = 0.009). Conclusions Data from the present study indicate that the combination therapy of nail dynamization and fESWT leads to a higher union rate than dynamization or fESWT alone. Level of evidence Level 3.
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