gms | German Medical Science

68. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie
90. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie
45. Tagung des Berufsverbandes der Fachärzte für Orthopädie in Zusammenarbeit mit dem Deutschen Verband für Physiotherapie – Zentralverband der Physiotherapeuten/Krankengymnasten

19. bis 23.10.2004, Berlin

Die extrakorporale Stosswellentherapie(ESWT) in der Behandlung von Skaphoidpseudarthrosen

Meeting Abstract (DGU 2004)

Suche in Medline nach

  • presenting/speaker Y. Onuma - Shonankamakura Klinik, Orthopaedie, Kamakura City
  • O. Iwata - Shonankamakura Klinik, Orthopaedie, Kamakura City
  • M. Taki - Shonankamakura Klinik, Orthopaedie, Kamakura City
  • M. Shiono - Shonankamakura Klinik, Orthopaedie, Kamakura City

Deutsche Gesellschaft für Unfallchirurgie. Deutsche Gesellschaft für Orthopädie und orthopädische Chirurgie. Berufsverband der Fachärzte für Orthopädie. 68. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 90. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie und 45. Tagung des Berufsverbandes der Fachärzte für Orthopädie. Berlin, 19.-23.10.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dguE1-675

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgu2004/04dgu0125.shtml

Veröffentlicht: 19. Oktober 2004

© 2004 Onuma et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

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Introduction

Scaphoid fractures are difficult to repair and frequently result in nonunions. Several researchers have reported their experiences in treating scaphoid nonunions, which involved the use of their various techniques. However, the treatment strategies for scaphoid nonunions are surrounded by several controversial issues.

It is reported that extracorporeal shock wave therapy (ESWT) appears to be an effective noninvasive tool for bone healing. Since 1997, we have performed ESWT for nonunions and have reported on the effects of this treatment.

The purpose of this study was to evaluate the effect of ESWT for scaphoid nonunions.

Methods

Since 1997, 13 patients with scaphoid nonunions have been treated with ESWT. Among the six athletes and the seven non-athletes, fourteen cases of scaphoid nonunions were detected. One athlete had a bilateral nonunion. Nine patients were male and four patients were female with an average age of 28.9 years (range, 16 to 53 years). Three patients were injured by traffic accident and four patients were injured by falling down. Six athletes participated in the following sports: American football (2), soccer (2), snow boarding (1), and volleyball (1). The time interval between the initial injury and the treatment averaged 2.7 years (range, 5 months to 20 years).

Every treatment was performed under plexus anesthesia. The treatment device was the OssaTron (High Medical Technologies, Switzerland). The shock wave intensity and the number of shock waves were 0.25 J/mm2 (20 kv), and 1500 shots, respectively. After this treatment, the fracture site was fixed with a cast for 5 weeks (A long arm thumb spica cast for the first 2 weeks, and a short arm thumb spica cast for the next 3 weeks).

We analyzed the bony consolidation in sequential radiographs with posteroanterior, lateral, 30° oblique, and stress posteroanterior views, with maximal ulnar deviation and conventional tomography. A return to sports was permitted only when the patient was able to participate without restrictions caused by pain or without the use of a supportive device after obtaining the radiographic union.

Results

The average follow-up period was 9 months (range, 6 months to 2.5 years). A radiographic union occurred in ten of the fourteen scaphoids. The average duration for the occurrence of the union was 10.3 weeks (range, 8 to 16 weeks). The time taken by the athletes for complete return to sports was averaged at 4.5 months (range, 2 to 6 months). No complications were observed in any of the cases after this treatment.

Conclusions

ESWT is an extremely safe, noninvasive, and effective alternative method in the treatment of scaphoid nonunions.