High-energy extracorporeal shockwave therapy in humeral delayed and non-unions.

Introduction: Within the last few decades, focused high-energy extracorporeal shockwave therapy (ESWT) has proven to be an effective alternative to standard of care revision surgery in delayed healing fractures or manifest non-unions in various anatomical regions. Materials and methods: A retrospect...

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Publicado en:European Journal of Trauma & Emergency Surgery Vol. 48; no. 4; pp. 3043 - 3050
Autores principales: Dahm, Falko, Feichtinger, Xaver, Vallant, Sascha-Mario, Haffner, Nicolas, Schaden, Wolfgang, Fialka, Christian, Mittermayr, Rainer
Formato: research tables/charts Journal Article
Publicado: Springer Nature Aug2022
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2022
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00068-021-01782-1
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        atl: High-energy extracorporeal shockwave therapy in humeral delayed and non-unions.
      aug:
        au:
          Dahm, Falko
          Feichtinger, Xaver
          Vallant, Sascha-Mario
          Haffner, Nicolas
          Schaden, Wolfgang
          Fialka, Christian
          Mittermayr, Rainer
        affil: AUVA Trauma Center Meidling, Kundratstr. 37, 1120, Vienna, Austria
      sug:
        subj:
          Ultrasonic Therapy Methods
          Humeral Fractures Rehabilitation
          Fractures, Ununited Rehabilitation
          Fracture Healing Evaluation
          Treatment Outcomes Evaluation
          Human
          Retrospective Design
          Multivariate Analysis
          Trauma Centers
          Humeral Fractures Radiography
          Fractures, Ununited Radiography
          Tomography, X-Ray Computed
          Prospective Studies
          Descriptive Statistics
          Diaphyses
          Regression
          Age Factors
          Fracture Dislocation
          Male
          Female
          Adolescence
          Young Adult
          Adult
          Middle Age
          Aged
          Aged, 80 and Over
          Adolescent: 13-18 years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: Introduction: Within the last few decades, focused high-energy extracorporeal shockwave therapy (ESWT) has proven to be an effective alternative to standard of care revision surgery in delayed healing fractures or manifest non-unions in various anatomical regions. Materials and methods: A retrospective multi-variant analysis of an open prospective, single-armed clinical study was conducted. Patients receiving focused high-energy ESWT for a delayed healing or an apparent non-union of a humeral fracture between January 1999 and December 2015 at a single trauma center were included in the study. Bony healing was defined as cortical continuity in three of four cortices and pain-free force loading and evaluated using CT scans and clinical examination at three- and six-month follow-ups after ESWT. Results: A total of 236 patients were included. N = 93 (43.8%) showed bony consolidation three months after ESWT and n = 105 (52.5%) after six months. Sub-group analysis showed significantly better healing for the proximal metaphyseal humerus (66.7% after six months, n = 42) compared to the diaphyseal region (48.1%, n = 133) and distal metaphyseal humerus (48.1%, n = 25). Regression analysis indicated significantly increased healing rates for patients of younger ages (p = 0.001) and a fracture diastasis of less than 5 mm (p = 0.002). Conclusion: The findings of this study indicate that ESWT can be considered as a treatment option for a well-selected patient population despite the lower healing rates compared to other anatomical regions.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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