gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Comparing non-vascularized scaphoid reconstruction for scaphoid nonunion with or without an intraoperative, single shock wave therapy (ESWT) – preliminary results

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  • presenting/speaker Marion Mühldorfer-Fodor - Klinik für Handchirurgie, Bad Neustadt a.d. Saale, Rhön-Klinikum AG, Bad Neustadt a.d. Saale, Germany
  • Jörg Van Schoonhoven - Klinik für Handchirurgie, Bad Neustadt a.d. Saale, Rhön-Klinikum AG, Bad Neustadt a.d. Saale, Germany
  • Karl Josef Prommersberger - Klinik für Handchirurgie, Bad Neustadt a.d. Saale, Rhön-Klinikum AG, Bad Neustadt a.d. Saale, Germany

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1974

doi: 10.3205/19ifssh0418, urn:nbn:de:0183-19ifssh04184

Veröffentlicht: 6. Februar 2020

© 2020 Mühldorfer-Fodor et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objectives/Interrogation: Does an intraoperative, single application of focused ESWT improve the consolidation of the scaphoid after reconstruction with a non-vascularized bone graft to treat scaphoid nonunion?

Methods: In a prospective, randomized study, patients with a scaphoid nonunion, mostly with compromised vascularity of the proximal pole fragment, had scaphoid reconstruction with a non-vascularized bone graft. Surgery was combined with focused, high-energy ESWT intraoperatively (intervention) or not (control group). Bony consolidation was evaluated by CT scans at 12 and 18 weeks, in case of failing or incomplete healing additionally at 24 weeks. The rate of patients without scaphoid consolidation after 24 weeks was calculated for each group. In those patients with a finally healed scaphoid, the extent of consolidation across the bone graft was assessed for each CT examination.

Results and Conclusions: In this ongoing study, 58 patients were enrolled so far, of which 9 did not finish follow up till 24 weeks. The rate of persistent nonunion was 22% in the ESWT group and 38% in the control group. Among the patients with scaphoid consolidation, the extent of scaphoid consolidation was 84% of the scaphoid's square area after ESWT and 73% in the control group 12 weeks postoperatively, 86% and 84% at 18 weeks, and 91% and 88% at 24 weeks.