The effects of extracorporeal shockwave on acute high-energy long bone fractures of the lower extremity
The effects of extracorporeal shockwave on acute high-energy long bone fractures of the lower extremity
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DOI：
10.1007/s00402-006-0236-0
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发表时间：
2007-02-01
影响因子：
2.3
通讯作者：
Fu, Te-Hu
中科院分区：
文献类型：
--
作者：
Wang, Ching-Jen;Liu, Hao-Chen;Fu, Te-Hu
高能量下肢长骨骨折存在骨折愈合不良和骨不连率高的风险。体外冲击波治疗长骨骨折骨不连效果显著。然而，冲击波对急性骨折的影响尚不清楚。本研究的目的是探讨冲击波对急性高能量骨折的下肢。材料和方法2004年1月至10月，56例59急性高能量骨折患者参加了这项研究。将患者随机分为两组，研究组28例患者28处骨折，对照组28例患者31处骨折。两组患者的年龄、性别、骨折类型和随访时间相似。研究组患者在一周中的奇数天接受手术后立即切开复位内固定和冲击波治疗，而对照组患者在一周中的偶数天接受切开复位内固定而不接受冲击波治疗。两组的术后管理相似，包括患肢无负重拐杖行走，直到X线片显示骨折愈合。评价参数包括疼痛评分和受累腿的负重状态的临床评估以及3、6和12个月时的系列X线片。结果12个月时，实验组骨折不愈合率为11%，对照组为20%（P < 0.001）;术后3、6、12个月观察组骨折愈合率均明显优于对照组（P < 0.001）。结论体外冲击波治疗下肢急性高能量骨折可有效促进骨折愈合，降低骨不连率。
Introduction High-energy long bone fractures of the lower extremity are at risk of poor fracture healing and high rate of non-union. Extracorporeal shockwave was shown effective to heal non-union of long bone fracture. However, the effect of shockwave on acute fractures is unknown. The purpose of this study was to investigate the effects of shockwave on acute high-energy fractures of the lower extremity.Materials and methods Between January and October 2004, 56 patients with 59 acute high-energy fractures were enrolled in this study. Patients were randomly divided into two groups with 28 patients with 28 fractures in the study group and 28 patients with 31 fractures in the control group. Both groups showed similar age, gender, type of fracture and follow-up time. Patients in the study group received open reduction and internal fixation and shockwave treatment immediately after surgery on odd-numbered days of the week, whereas, patients in the control group received open reduction and internal fixation without shockwave treatment on even-numbered days of the week. Postoperative managements were similarly performed in both groups including crutch walking with non-weight bearing on the affected limb until fracture healing shown on radiographs. The evaluation parameters included clinical assessments of pain score and weight bearing status of the affected leg and serial radiographs at 3, 6 and 12 months. The primary end-point is the rate of non-union at 12 months, and the secondary end point is the rate of fracture healing at 3, 6 and 12 months.Results At 12 months, the rate of non-union was 11% for the study group versus 20% for the control group (P < 0.001). Significantly, better rate of fracture healing was noted in the study group than the control group at 3, 6 and 12 months (P < 0.001).Conclusions Extracorporeal shockwave is effective on promoting fracture healing and decreasing the rate of non-union in acute high-energy fractures of the lower extremity.