A prospective clinical study investigated the effectiveness of shock waves
in the treatment of 72 patients with 72 nonunions of long bone fractures (4
1 femurs, 19 tibias, seven humeri, one radius, three ulnas and one metatars
al). The doses of shock waves were 6000 impulses at 28 kV for the femur and
tibia, 3000 impulses at 28 kV for the humerus, 2000 impulses at 24 kV for
the radius and ulna, and 1000 impulses at 20 kV for the metatarsal, The res
ults of treatment were assessed clinically, and fracture healing was assess
ed with plain radiographs and tomography, The rate of bony union was 40% at
3 months, 60.9% at 6 months, and 80% at 12 months followup, Shock wave tre
atment was most successful in hypertrophic nonunions and nonunions with a d
efect and was least effective in atrophic nonunions, There were no systemic
complications or device-related problems. Local complications included pet
echiae and hematoma formation that resolved spontaneously. In the authors'
experience, the results of shock wave treatment were similar to the results
of surgical treatment for chronic nonunions with no surgical risks. Shock
wave treatment is a safe and effective alternative method in the treatment
of chronic nonunions of long bones.