Clinical evaluation of efficiency of extracorporeal shockwave therapy for nonunion of tubular bones

Abstract

Aim. To establish the efficiency of using focal extracorporeal shockwave therapy for nonunion of tubular bones. Material and Methods. Forty-two patients with nonunion of tubular bones were examined and distributed into two groups: 23 (54.76%) patients were included in the study group, and 19 (45.24%) - in the control group. The patients of the study group underwent 4-7 procedures of focal shockwave therapy by Swiss DolorClast. Patients in the control group were treated surgically. The results of treatment were evaluated using the Neer-Grantham-Shelton (1967) scale in the modification of D. Cherkes-Zade, M. Monesi, A. Causero, and M. Marcolini (2003). The probability of an error-free prediction was set at pЈ0.05. Statistical processing of the obtained results was performed using Statistica 10 program. Results and Discussion. On comparison of the long-term results of treatment in the patients of the study group, there were significantly better indicators that showed an anatomical shortening of the segment (p=0.01) and work capacity restoration (p=0.048), compared to patients in the control group. According to the indicators of severity of pain, limitation of movements, X-ray changes and total results of treatment, no significant difference was found between the groups (p> 0.05). Conclusions. The absence of a significant difference in the total results of surgical treatment and the use of conservative stimulation of reparative osteogenesis may allow implementation of focal extracorporeal shockwave therapy as an alternative treatment for nonunion.

Keywords

• nonunion, fracture healing complication, extracorporeal shockwave therapy, fractures of tubular bones, stimulation of reparative osteogenesis