Does radial shock wave therapy works in pseudarthrosis? Prospective analysis of forty four patients
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ORIGINAL PAPER
Does radial shock wave therapy works in pseudarthrosis? Prospective analysis of forty four patients Paulo F. Kertzman 1
&
Patricia M. B. Fucs 1
Received: 3 August 2020 / Accepted: 13 August 2020 # SICOT aisbl 2020
Abstract Summary Introduction In this study, we analyze a new treatment option for pseudarthrosis using radial shock waves. The traditional treatment to pseudarthrosis is surgical. As an option to specific cases, focal shock waves seem to present good results with bone union without a subsequent surgical procedure. As radial shock waves reach less energy and less depth penetration than focal shock waves, they usually are not indicated for the treatment of pseudarthrosis of any bone segment. There are publications that show evidences of the action of radial shock waves stimulating bone consolidation in vitro, in animals and in humans. We will present a new option for failure of consolidation in superficial bones submitted to radial shock wave therapy. Objective To analyze the effectiveness of radial shock waves in the treatment of superficial bone pseudarthrosis. Patients and methods Between 2016 and 2019, we conducted a prospective study with 44 consecutive patients with pseudarthrosis. All patients had prior indication for treatment with surgery and were treated with radial shock waves as a nonsurgical treatment option. Patients were evaluated clinically and radiographically pre-treatment and 6 months after. Clinically, patients complained of pain and dysfunction, according to the segment affected, and radiographically, evidences of pseudarthrosis in at least two X-ray views. As the outcomes: satisfactory when there was bone union, no pain, and return function; unsatisfactory when there was no bone union and maintain pain and dysfunction. All patients were treated with the same equipment and by the same physician. The treatment consisted in 3 sessions with weekly interval; in each session, 3000 radial shock waves were applied with 4 bar of energy. Results After 6 months, clinical analysis and X-ray evidence on 77.2% of the patients presented bone union and clinical improvement classified as satisfactory result. There were no complications. Conclusion Treatment of pseudarthrosis in superficial bones with radial shock waves is effective and safe. Keywords Pseudarthrosis . Shock waves . Radial shock waves
Introduction In this study we present an innovative method for the treatment of pseudarthrosis in superficial bones with radial shock waves therapy. Despite the current methods in the surgical treatment of fractures, with minimally invasive techniques and better fixation, about 3 to 15% of cases were evaluated with a failure in consolidation. Pseudarthrosis is considered the fail in
* Paulo F. Kertzman [email protected] 1
Orthopaedic Department of Santa Casa, São Paulo, Brazil
consolidation after six months of initial trauma, with no signs of bone union in the last three months. There are authors who advocate up to nine months for the definition of pseudarthrosis, but there
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