Effect of extra-corporeal shock wave therapy in Cases of nonunion and delayed union of bones
Journal Title: MedPulse -International Medical Journal - Year 2015, Vol 2, Issue 6
Abstract
Introduction: Long bone fractures are common in field of Orthopedics trauma and it requires careful treatment to avoid refractory disabilities. With newer modalities of treatment and better quality implants for fracture fixation, most of the complications have been reduced. Even though this is true, non union and delayed union remains one of the major complication after skeletal trauma or elective surgery and surgical modality of treatment of such chronic nonunion has its own dreaded complications which has produced a need of an effective and simple nonsurgical method of nonunion treatment. Material and methods: 35 patients of diagnosed long bone nonunion were included in the study. All patients received shock wave treatment. The intensity of shock wave varied depending on bone fractured and area of fracture gap. The shock waves were applied in two planes and the region of metallic internal fixation such as cortical plates was avoided..Presence of intramedullary rod did not interfere with application of shock wave and was not a contraindication for shock wave therapy. Results: It was observed that out of 26 patients with hypertrophic nonunion, 21 patients showed signs of union or clinical improvement after ESWL treatment. Two out of remaining 5 patients showed consolidation after second dose of ESWT whereas remaining three cases of hypertrophic nonunion were treated by surgery. While out of 7 atrophic non union 3 showed union while remaining 4 showed no union on x ray or no clinical improvement at all. Out of these four, three got operated for persistency of nonunion while one patient was not willing for surgery. Conclusion: Extracorpeal shock wave therapy is an effective noninvasive method of nonunion treatment with comparable positive results to surgical modality of treatment. Further if stringent selection criteria were used (fracture gap less than 5 mm, patient with hypertrophic nonunion) the success rate would have been higher.
Authors and Affiliations
Mukesh Phalak, Saumil Patel, Deepak Joshi, A B Goregaonkar
Keywords
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