HIGH-ENERGY EXTRACORPOREAL SHOCK-WAVE THE RAPY (ESWT) FOR TREATMENT OF PSEUDOARTHROSIS

Problem: The success rate of high-energy extracorporal shock wave ther apy in the treatment of non-unions in comparison to the ''golden stand ard'' surgery is still unclear. Method: In a prospective study, 3000 i mpulses with an energy density of 0,6 mJ/mm(2) were applied with an ex perimental device to the pseudarthrosis in 52 patients. Results: The m ean duration of pseudarthrosis was 13 months. A mean of 2.5 surgical i nterventions had already been performed. Bony union was achieved in 52 % of our patients after an average of 3.3 months. Failures especially were found in the atrophic type of pseudarthrosis as well as in congen ital bone disorders like fibrous dysplasia or osteogenesis imperfecta. No serious complications were observed. Conclusions: Even after numer ous surgical interventions high-energy extracorporal shock wave therap y as a noninvasive method for the treatment of bony non-unions showed a fair success rate. A higher success rate can be expected by strict s election criteria.