Nonoperative stimulation of osteogenesis for delayed union of fractures of tubular bones

Aim — to assess the efficiency of the using focal extracorporeal shockwave therapy (fESWT) for delayed union of fractures of tubular bones. Object and methods. 25 patients with delayed union of fractures of tubular bones were examined (the average age was 40.24±16.55 years). Among the examined patients were formed investigated group, which consists of 13 (52.0%) patients and control group included 12 (48.0%). Patients of the investigated group were given 5–7 procedures of fESWT with an interval of 5–6 days. The main method of treating of patients of the control group was surgical. Neer — Grantham — Shelton scale with modification D. Cherkes-Zade et al. (2003) was used to evaluate the results of the treatment. Results. As a result, fracture healing was founded in 11 (84.6%) patients of the investigated group, 3 (23.1%) showed signs of malunion, that did not worsen the functional capacity of the limb. There was no significant difference between the long-term results in patients of both groups for indicators of pain syndrome (p=0.34), presence of anatomical shortening (p=0.39), limitation of movement (p=0.37), radiologic changes (p=0.25), work capacity (p=0.27) and total results (p=0.66). Conclusions. The absence of significant difference in the results of surgical treatment and the using fESWT allows recommending it as an alternative treatment for delayed union.