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M. Gautam1, A. Khadka2, S. Adhikari3
1Shree Birendra Hospital, Kathmandu, Nepal, 2Nepales Army Institute of Health Sciences, Pharmacology, Kathmandu, Nepal, 3Kathmandu University, Physiotherapy, Dhulikhel, Nepal
Background: Nonunion is the common complication of long bone fracture. Even though extracorporeal shock wave therapy (ESWT) has been used in treating nonunion of long bone fractures, its effectiveness among various long bones is inconclusive.
Purpose: To compare the effectiveness of ESWT in healing of nonunion fractures of Humerus, Tibia and Femur.
Methods: The prospective study involved total 15 patients diagnosed as nonunion of long bone fractures (4 Femur, 7 Tibia and 4 Humerus) based on no radiographic progress towards union for 6 consecutive months. Four sessions of ESWT with energy flux of 0.25 mJ/mm2 at 10 Hz and 3000 shocks each session were delivered over a period of 1 month. The patients were followed up for 1 year after completion of their last ESWT session. The effectiveness was measured with radiological union scale (RUS).Wilcoxon signed rank test and Mann Whitney U test were used to analyze data within groups and between groups respectively.
Results: The RUS demonstrated significant improvement with treatment (Z= -3.035, P= 0.001) within group comparison. Femur and humerus groups showed no significant difference while tibia group demonstrated significant difference. During between groups comparison, the tibia group demonstrated significant improvement (U=2.0, P=0.03) compared to humerus group.
Conclusion(s): ESWT is useful therapeutic intervention to enhance union during non-union complications of fracture of long bones. However, large scaled clinical trials are recommended.
Implications: Application of ESWT is effective in nonunion of long bone fracture which reduces the number of re-surgeries and widens the scope of Physiotherapy practice.
Funding, acknowledgements: The work was not funded by any person or organizations.
Keywords: ESWT, Nonunion, Long bones
Topic: Electrophysical & isothermal agents
Did this work require ethics approval? No
Institution: Nepalese Army Institute of Health Sciences
Committee: Nepal Health Research Council
Reason: The procedure was normal therapeutic Intervention
All authors, affiliations and abstracts have been published as submitted.
