Extracorporeal shockwave therapy for atrophic and oligotrophic nonunion of tibia and femur in high energy trauma patients. Case series

Carlos Sandoval, Álvaro Valenzuela, Carlos Rojas, Manuel Brañes, Leonardo Guiloff

Resultado de la investigación: Article

1 Cita (Scopus)

Resumen

Background High energy diaphyseal fractures constitute a complicated matter for trauma units and urgent medical and surgical decisions to prompt stabilization of these patients, might leave some skeletal distortions that affect bone union. The objective is to evaluate the safety and efficacy of extracorporeal shockwave therapy (ESWT), as a treatment for patients with atrophic or pseudoatrophic nonunion. Patients and Methods Case series which included 50 patients with nonseptic and stable nonunion diaphyseal fracture of femur and tibia. They received a defined protocol of up to three high-energy ESWT (10.000 shocks per session). Each patient was evaluated with x-rays or CT between 4 and 6 weeks, to determine the necessity to continue the protocol and obtain data about initial periosteal-endosteal responses and its evolution. We analyzed, semi-quantitatively, the volume of the fracture zone from initial CT using a mathematical method to calculate the volume in cylinders, and confronting this data with Winquist Classification. Results 17/25 (68%) tibia and 13/25 (52%) femur nonunion were treated successfully. There were no complications during or after treatment. Conclusions ESWT induced bone healing in an average 60% of cases, which is consistent with current reported literature. CT studies gave some clues to patients' real condition of fracture anatomy before treatment, allowing a better decision in the orientation of ESWT application for each case. Volumetric Fracture Analysis for Winquist Classification shown that ESWT was able to induce significant bone regeneration in fractures with high volume. This kind of therapy was well accepted in reluctant patients to invasive methods.

Idioma originalEnglish
Páginas (desde-hasta)36-40
Número de páginas5
PublicaciónInternational Journal of Surgery Open
Volumen9
DOI
EstadoPublished - 1 ene 2017
Publicado de forma externa

Huella dactilar

Tibia
Femur
Wounds and Injuries
Therapeutics
Convulsive Therapy
Bone and Bones
Bone Regeneration
Trauma Centers
Anatomy
X-Rays
Safety

ASJC Scopus subject areas

  • Surgery

Citar esto

Sandoval, Carlos ; Valenzuela, Álvaro ; Rojas, Carlos ; Brañes, Manuel ; Guiloff, Leonardo. / Extracorporeal shockwave therapy for atrophic and oligotrophic nonunion of tibia and femur in high energy trauma patients. Case series. En: International Journal of Surgery Open. 2017 ; Vol. 9. pp. 36-40.
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title = "Extracorporeal shockwave therapy for atrophic and oligotrophic nonunion of tibia and femur in high energy trauma patients. Case series",
abstract = "Background High energy diaphyseal fractures constitute a complicated matter for trauma units and urgent medical and surgical decisions to prompt stabilization of these patients, might leave some skeletal distortions that affect bone union. The objective is to evaluate the safety and efficacy of extracorporeal shockwave therapy (ESWT), as a treatment for patients with atrophic or pseudoatrophic nonunion. Patients and Methods Case series which included 50 patients with nonseptic and stable nonunion diaphyseal fracture of femur and tibia. They received a defined protocol of up to three high-energy ESWT (10.000 shocks per session). Each patient was evaluated with x-rays or CT between 4 and 6 weeks, to determine the necessity to continue the protocol and obtain data about initial periosteal-endosteal responses and its evolution. We analyzed, semi-quantitatively, the volume of the fracture zone from initial CT using a mathematical method to calculate the volume in cylinders, and confronting this data with Winquist Classification. Results 17/25 (68{\%}) tibia and 13/25 (52{\%}) femur nonunion were treated successfully. There were no complications during or after treatment. Conclusions ESWT induced bone healing in an average 60{\%} of cases, which is consistent with current reported literature. CT studies gave some clues to patients' real condition of fracture anatomy before treatment, allowing a better decision in the orientation of ESWT application for each case. Volumetric Fracture Analysis for Winquist Classification shown that ESWT was able to induce significant bone regeneration in fractures with high volume. This kind of therapy was well accepted in reluctant patients to invasive methods.",
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Extracorporeal shockwave therapy for atrophic and oligotrophic nonunion of tibia and femur in high energy trauma patients. Case series. / Sandoval, Carlos; Valenzuela, Álvaro; Rojas, Carlos; Brañes, Manuel; Guiloff, Leonardo.

En: International Journal of Surgery Open, Vol. 9, 01.01.2017, p. 36-40.

Resultado de la investigación: Article

TY - JOUR

T1 - Extracorporeal shockwave therapy for atrophic and oligotrophic nonunion of tibia and femur in high energy trauma patients. Case series

AU - Sandoval, Carlos

AU - Valenzuela, Álvaro

AU - Rojas, Carlos

AU - Brañes, Manuel

AU - Guiloff, Leonardo

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background High energy diaphyseal fractures constitute a complicated matter for trauma units and urgent medical and surgical decisions to prompt stabilization of these patients, might leave some skeletal distortions that affect bone union. The objective is to evaluate the safety and efficacy of extracorporeal shockwave therapy (ESWT), as a treatment for patients with atrophic or pseudoatrophic nonunion. Patients and Methods Case series which included 50 patients with nonseptic and stable nonunion diaphyseal fracture of femur and tibia. They received a defined protocol of up to three high-energy ESWT (10.000 shocks per session). Each patient was evaluated with x-rays or CT between 4 and 6 weeks, to determine the necessity to continue the protocol and obtain data about initial periosteal-endosteal responses and its evolution. We analyzed, semi-quantitatively, the volume of the fracture zone from initial CT using a mathematical method to calculate the volume in cylinders, and confronting this data with Winquist Classification. Results 17/25 (68%) tibia and 13/25 (52%) femur nonunion were treated successfully. There were no complications during or after treatment. Conclusions ESWT induced bone healing in an average 60% of cases, which is consistent with current reported literature. CT studies gave some clues to patients' real condition of fracture anatomy before treatment, allowing a better decision in the orientation of ESWT application for each case. Volumetric Fracture Analysis for Winquist Classification shown that ESWT was able to induce significant bone regeneration in fractures with high volume. This kind of therapy was well accepted in reluctant patients to invasive methods.

AB - Background High energy diaphyseal fractures constitute a complicated matter for trauma units and urgent medical and surgical decisions to prompt stabilization of these patients, might leave some skeletal distortions that affect bone union. The objective is to evaluate the safety and efficacy of extracorporeal shockwave therapy (ESWT), as a treatment for patients with atrophic or pseudoatrophic nonunion. Patients and Methods Case series which included 50 patients with nonseptic and stable nonunion diaphyseal fracture of femur and tibia. They received a defined protocol of up to three high-energy ESWT (10.000 shocks per session). Each patient was evaluated with x-rays or CT between 4 and 6 weeks, to determine the necessity to continue the protocol and obtain data about initial periosteal-endosteal responses and its evolution. We analyzed, semi-quantitatively, the volume of the fracture zone from initial CT using a mathematical method to calculate the volume in cylinders, and confronting this data with Winquist Classification. Results 17/25 (68%) tibia and 13/25 (52%) femur nonunion were treated successfully. There were no complications during or after treatment. Conclusions ESWT induced bone healing in an average 60% of cases, which is consistent with current reported literature. CT studies gave some clues to patients' real condition of fracture anatomy before treatment, allowing a better decision in the orientation of ESWT application for each case. Volumetric Fracture Analysis for Winquist Classification shown that ESWT was able to induce significant bone regeneration in fractures with high volume. This kind of therapy was well accepted in reluctant patients to invasive methods.

KW - Atrophic

KW - Non-union

KW - Oligotrophic extracorporeal shockwave therapy

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U2 - 10.1016/j.ijso.2017.09.002

DO - 10.1016/j.ijso.2017.09.002

M3 - Article

AN - SCOPUS:85032291632

VL - 9

SP - 36

EP - 40

JO - International Journal of Surgery Open

JF - International Journal of Surgery Open

SN - 2405-8572

ER -