高能体外震波(ESWT)治疗长骨骨不连

Extracoporeal shock wave therapy in nonunion or delayed union of long bones

[目的]探讨使用高能体外震波(ESWT)治疗长骨骨不连的效果。[方法]本组20例长骨骨折切开复位内固定或石膏外固定治疗后骨不连,2例萎缩型,18例增生型。采用C臂机结合OssatronESWT治疗仪,分别取尺、桡骨24kv,肱骨26kv,胫骨、股骨28kv的震波强度,尺、桡骨1500次,肱骨3000次,股骨及胫骨6000次。[结果]平均随访15.2个月。8例3个月后骨愈合,6例4个月后骨愈合,3例5个月后骨愈合,1例6个月后仍未愈合,再次行ESWT治疗后4个月愈合,2例6个月后未愈合,行切开复位内固定+植骨后愈合。平均愈合时间为3.9个月,愈合率达90%。[结论]ESWT可以做为治疗长骨骨不连及骨延迟愈合的有效治疗方法。

[Objective] To explore the effect of extracoporeal shock wave therapy （ESWT） in nonunion of long bones. [Methods] Twenty cases of long bone fractures received open reduction and intemal fixation or plaster extemal fixation, in which 2 cases were oligotrophic and 18 cases were hypertrophic. All cases were found nonunion and so were treated with Ossatron ESWT machine combined with C-arm X ray machine, and different shock wave densities were used as following;24 kv and 1 500 times for radius and ulna; 26 kv and 3 000 times for humerus; 28 kv and 6000 times for femur and tibia.[ Result] An average 15.2 months＇follow up was carried out after ESWT therapy. Seventeen cases resulted in bone healing 3 to 5 months after ESWT. Bone healing was not observed in one case 6 months after the first ESWT, the second ESWT was carried out for 4 months until the final bone union. Another 2 cases remained nonunion 6 months after ESWT and open reduction and intemal fixation combined with autogtografting were carried out to achieve final bone healing. The average healing period of all cases was 3.8 months. [Conclusion] ESWT is an effective method to treat nonunion or delayed osseous union of long bones.