Clinical Study on the Treatment of Long Bone Fracture Non-Union with Extracorporeal Shock Wave Therapy Combined with Platelet-Rich Plasma

Abstract

Objective: The objective of the study was to evaluate of the therapeutic efficacy of extracorporeal shock wave therapy (ESWT) combined with platelet-rich plasma (PRP) injection in patients with long bone fracture non-union. Material and Methods: A total of 36 patients identified with long bone fracture non-union treated from September 2020 to September 2023 were enrolled into this study. Employing a random number table method, they were randomly divided into three groups, with 12 cases in each group. Based on the treatment modality, the groups were categorized as the ESWT group, PRP group, and combination ESWT + PRP group. Routine radiographs and musculoskeletal ultrasound were obtained before treatment and at 3-, 6-, and 9-month post-treatment intervals to observe for bone callus formation and assess fracture line imaging scores with the aim to evaluate the treatment efficacy of each group. Results: With the extension of treatment time, the bone callus and fracture line imaging scores of the three groups gradually increased (P < 0.05). At 3-, 6-, and 9-month post-treatment, the scores of the ESWT combined with the PRP group were significantly better than those of the singular ESWT group and PRP group, and the differences were statistically significant (P < 0.05). Conclusion: Therapy with singular ESWT, singular PRP, and combination ESWT + PRP has demonstrated effective improvement in fracture healing for patients with long bone fracture non-union. The synergistic effects of combination therapy were more significant, surpassing the efficacy of singular ESWT or PRP applications. The combined use of ESWT and PRP represents a safe and promising alternative treatment for long-bone fracture non-union, making it a compelling choice in the context of fracture healing. Keywords: Extracorporeal shock wave therapy, Platelet-rich plasma, Non-union of fracture.