体外冲击波治疗骨不愈的临床观察

Treatment of bone nonunions with extracorporeal shock waves

目的观察体外冲击波治疗骨不愈的疗效及安全性。方法应用体外震波碎石机所产生的高能震波对25例骨折不愈合病人进行治疗,每月复查X线片检查,了解骨折愈合情况。震波治疗3个月后如骨折处无明显骨痂生长,则再行一次震波治疗。结果震波治疗后,骨痂出现时间为4～11周,平均9周。25例中,5例无效;20例有较明显骨痂生长,其中18例最终骨折完全愈合,骨折愈合时间为10～21周,平均14周。治疗总有效率为80%,治愈率为72%。震波治疗后未观察到肢体神经血管损伤等并发症。结论体外冲击波治疗骨不愈疗效可靠、创伤小、方法简单安全,可作为治疗骨不愈的首选方法。

Objective To investigate the effectiveness and safety of extracorporeal shock waves (ESW) for treatment of bone nonunions. Methods A total of 25 patients with bone nonunions were treated with ESW. X-ray of the fracture site was taken once every month to observe healing of the fractures. A second procedure of ESW was delivered to fractures that did not show obvious callus formation 3 months following the first procedure of ESW. Results Callus was seen 4 to 11 weeks (9 weeks on average) following ESW. Obvious callus formation was seen in 20 cases, among which 18 achieved bone healing in 10 to 21 weeks, with an average of 14 weeks. Bone union was seen in 72% of the cases. The overall effective rate was 80%. There were no severe side effects. Conclusion ESW is a safe, simple and effective method for treatment of bone nonunion.