Extracorporeal shockwave therapy (ESWT) – First choice treatment of fracture non-unions?

• Published in: International journal of surgery (London, England) Vol. 24; no. Pt B; pp. 179 - 183
• Main Authors: Schaden, Wolfgang, Mittermayr, Rainer, Haffner, Nicolas, Smolen, Daniel, Gerdesmeyer, Ludger, Wang, Ching-Jen
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.12.2015
• Subjects: ESWT; Extracorporeal shockwave therapy; Fracture Healing; Fractures, Ununited - therapy; High-Energy Shock Waves - therapeutic use; Humans; Non-healing fractures; Non-union; Pseudarthroses; Surgery; Non-healing fractures; ESWT; Pseudarthroses; Non-union; Extracorporeal shockwave therapy
• ISSN: 1743-9191; 1743-9159
• DOI: 10.1016/j.ijsu.2015.10.003

Fracture non-unions are still a challenging problem in orthopedics. The treatment of non-unions remains highly individualized, complex, and demanding. In most countries the surgical approach with debridement of the non-union gap, anatomical reduction and appropriate osteosynthesis along with autologous bone grafting is considered as the standard of care. One of the very first non-urologic applications of extracorporeal shockwave treatment (ESWT) concerned non-healing fractures. Since the early 1990ties the knowledge of the working mechanism has increased enormously. The purpose of this review article is to demonstrate by peer-reviewed literature in conjunction with our own experiences that ESWT can be an efficient, non-invasive, almost complication-free and cost effective alternative to surgical treatment of non-healing fractures. •Non-healing fractures (pseudarthroses, non-unions) still are a challenging problem in orthopedics.•ESWT is a non-invasive procedure that achieves comparable results to surgical approaches.•Complications associated with ESWT are on rare occasions and minimal if present.•Peer-reviewed literature shows excellent results with medium/high energy focused ESWT, with faster return to competition and athletic activity.