体外冲击波在促进骨愈合中的应用

Application of extracorporeal shock wave to promote fracture healing

目的:观察体外冲击波促进骨折愈合、治疗骨不连的疗效。方法:选取22例外伤性骨折愈合延迟、骨不连患者进行体外冲击波冲击治疗,治疗后每4～6周进行X线片复查,观察骨折愈合情况。首次冲击波治疗12周后如骨折处无明显骨痂形成,则进行第2次冲击波治疗。冲击波能量为0.4mJ/mm2,每次脉冲总数为1600～2400次。结果:22例下肢外伤性骨折愈合延迟及骨不连经体外冲击波治疗后,骨性骨痂形成的时间为4～12周,20例有明显骨痂形成,其中17例在治疗后3～6个月内骨折完全愈合。2例胫骨下段骨折冲击波治疗无效。结论:体外冲击波在治疗骨不连,促进骨折愈合方面效果满意,有广阔的应用前景。

Objective-To observe the effect of extracorporeal shock wave （ESW） for the treatment of bone nonunion and promotion of fracture healing. Methods： Twenty-two patients with fractures of delayed union and nonunion were treated with ESW. The X-ray of the fracture was taken every 4 - 6 weeks to observe condition of fracture healing. The second procedure of ESW was delivered to fractures while the X-ray did not show obvious callus formation at 12 weeks after the first treatment. The energy of ESW was 0, 4 mJ/mm^2 and the total pulse of each time was 1 600 - 2 400 times. Results： The time of callus formation in the patients was 4 - 12 weeks after treatment. Twenty cases had obvious callus formation, in which 17 cases achieved fracture healing in 3 to 6 months. Two patients of distal tibial fracture showed no effect after treatment. Conclusion ： ESW has marked effect for treating bone nonunion and promoting fracture healing,which is promising in the future.