Abstract
BackgroundLong-bone non-unions after intramedullary nailing can be treated by nail dynamization or focused high-energy extracorporal shock wave therapy (fESWT). The objective of this study was to assess the effect of the combination therapy of nail dynamization and fESWT on long-bone non-unions.Materials and methods49 patients with long-bone non-unions (femur and tibia) after nailing were treated with nail dynamization (group D, n = 15), fESWT (group S, n = 17) or nail dynamization in addition to fESWT (group DS, n = 17). Patients were followed up for 6 months retrospectively. Furthermore, age, sex, Non-Union Scoring System (NUSS) score, time intervals from primary and last surgery until intervention and smoking status were analysed for their correlations to bone union.ResultsUnion rates were 60% for group D, 64.7% for group S and 88.2% for group DS, with a significant difference between group D and DS (p = 0.024). Successful treatment was correlated with high age (OR 1.131; 95% CI 1.009–1.268; p = 0.034), female gender (OR 0.009; 95% CI 0.000–0.89; p = 0.039), low NUSS score (OR 0.839; 95% CI 0.717–0.081; p = 0.028) and negative smoking status (OR 86.018; 95% CI 3.051–2425.038; p = 0.009).ConclusionsData from the present study indicate that the combination therapy of nail dynamization and fESWT leads to a higher union rate than dynamization or fESWT alone.Level of evidenceLevel 3.
Highlights
Fracture healing is a complex regenerative process that usually results in scar-free bone union [1]
Successful treatment was correlated with high age, female gender, low Non-Union Scoring System (NUSS) score and negative smoking status
Data from the present study indicate that the combination therapy of nail dynamization and focused high-energy extracorporal shock wave therapy (fESWT) leads to a higher union rate than dynamization or fESWT alone
Summary
Fracture healing is a complex regenerative process that usually results in scar-free bone union [1]. One of the most commonly performed procedures to mechanically accelerate fracture healing after nailing of long bones is nail dynamization This comprises the removal of proximal or distal locking screws in statically locked intramedullary nails in order to reduce the fracture gap and increase the compression force. This technique was initially intended to improve union rates during normal fracture healing. It is an economical and technically simple procedure for the treatment of Stolberg‐Stolberg et al Journal of Orthopaedics and Traumatology (2022) 23:4 long-bone non-unions. The objective of this study was to assess the effect of the combination therapy of nail dynamization and fESWT on long-bone non-unions
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have