体外冲击波治疗骨折不愈合的临床应用进展

Progress in clinical application of extracorporeal shock wave therapy for fracture nonunion

骨折不愈合在骨科,仍是一个具有挑战性的问题。骨折不愈合的治疗仍然是高度个性化、复杂和苛刻的。在大多数国家,清创不愈合间隙、解剖复位、适当的骨内固定和自体植骨被认为是治疗的标准。体外冲击波治疗(ESWT)最早的非泌尿系统应用之一涉及非愈合性骨折。自20世纪90年代初以来,ESWT在骨科中的应用及工作机制的报道逐渐增多,证实其是一种高效、无创、几乎无并发症和经济的非愈合性骨折手术治疗的替代方案。

Fracture nonunion is still a challenging problem in orthopedics,featuring its treatment being highly personalized,complex and demanding.In most countries,methods such as debridement of nonunion space,anatomical reduction,proper internal fixation and autogenous bone grafting are considered as the standard of its treatment.The extracorporeal shock wave therapy(ESWT)was first applied in the non-urinary system when nonunion fractures were involved.Since the early 1990s,there has been an increasing number of reports on the application and working mechanisms of ESWT in orthopedics,confirming it to be a highly effective,non-invasive,virtually complication-free and cost-effective alternative to the surgical treatment of nonunion fractures.