Abstract:

BACKGROUND: Extracorporeal shock wave (ESW) therapy is using principles of liquid-electric conversion and transfer to produce energy gradient difference and torsional tension in tissues with varied density. It is a matured technique in treating urinary and digestive system calculosis. However, the applications of ESW in treating nonunion or delayed osseous union are few.     
OBJECTIVE: To explore the therapeutic effects of ESW in treating nonunion or delayed osseous union by animal experiment and clinical verification.
METHODS: The effect of ESW on periosteal metabolism was explored by focusing extracorporeal wave on bone tissues, and the autoradiography of H3-TdR labeling rate was observed by animal experiment. ESW was used to treat nonunion patients (n=16) or delayed osseous union patients (n=16), and the follow-up results were evaluated.  
RESULTS AND CONCLUSION: By autoradiography, the H3-TdR labeling rate was greater in the experimental sides than that of the control sides at 1 and 2 weeks after operation (P < 0.05-0.01), which confirmed that the mitotic activity of periosteal osteoblasts was increased, namely, endosteal osteogenesis was enhanced. Clinical verification results demonstrated that, at 16 weeks after operation, 16 patients with delayed union were all cured, 13 were cured among the 16 cases of nonunion, and the remained 3 cases had notably callus formation. No adverse events occurred in all cases. The results suggested that it is reliable to treat nonunion or delayed osseous union using ESW therapy.