Title: Extracorporeal shockwave therapy for atrophic and oligotrophic nonunion of tibia and femur in high energy trauma patients. Case series
Authors: C. Carlos Sandoval, G. Álvaro Valenzuela, Carlos Alejandro Rojas, Brañes Manuel, W. Leonardo Guiloff
High-energy fractures of the tibia and femur can pose challenges in achieving proper bone union. In this study, extracorporeal shockwave therapy (ESWT) was evaluated as a safe and effective treatment for atrophic or pseudoatrophic nonunion in trauma patients. A case series of 50 patients with stable nonunion fractures received up to three sessions of ESWT, with a total of 10,000 shocks per session. X-rays or CT scans were used to assess the initial response and subsequent evolution of the fracture zone. The results showed successful treatment in 68% of tibia nonunions and 52% of femur nonunions, with no complications reported. The ESWT-induced bone healing rate of 60% aligns with previous research. CT studies provided valuable information about the fracture anatomy, aiding in determining the optimal application of ESWT for each case. Additionally, volumetric fracture analysis revealed that ESWT was effective in promoting significant bone regeneration in fractures with a high volume. Importantly, this non-invasive therapy was well received by patients who were hesitant about invasive methods. These findings underscore the potential of shockwave therapy as a beneficial approach for promoting bone healing in trauma patients with atrophic or pseudoatrophic nonunion fractures, providing a promising alternative for cases where traditional methods have shown limited success.
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