Biedermann Rainer, Martin Arho, Handle Gerhart, Auckenthaler Thomas, Bach Christian, Krismer Martin
Department of Orthopedics, University of Innsbruck, Austria.
J Trauma. 2003 May;54(5):936-42. doi: 10.1097/01.TA.0000042155.26936.03.
Nonunion remains a major complication after skeletal trauma. In the last decade, extracorporeal shock wave therapy has become a common tool for the treatment of nonunions. To date, no prospective, randomized trial has been conducted to show the efficacy of this form of treatment.
This study was performed to determine the value of extracorporeal shock wave therapy for nonunions. Previous published results in the literature and our own clinical results were analyzed and related to the natural history of bony union.
No study has proven that extracorporeal shock wave therapy improves bone healing. Clinical studies reporting the acceleration of union after application of shock waves instead seem to misinterpret the natural history of bony union.
No evidence supports the treatment of pseudarthroses with extracorporeal shock waves. A randomized, prospective, clinical trial with a control group has to be performed before a final decision can be made regarding this indication for extracorporeal shock wave therapy.
骨不连仍然是骨骼创伤后的主要并发症。在过去十年中，体外冲击波疗法已成为治疗骨不连的常用手段。迄今为止，尚无前瞻性随机试验证明这种治疗方式的疗效。
本研究旨在确定体外冲击波疗法对骨不连的治疗价值。分析了既往文献发表的结果以及我们自己的临床结果，并与骨愈合的自然病程进行关联。
尚无研究证实体外冲击波疗法可促进骨愈合。报道冲击波应用后骨愈合加速的临床研究似乎误解了骨愈合的自然病程。
没有证据支持用体外冲击波治疗假关节。在就体外冲击波疗法的这一适应证做出最终决定之前，必须进行有对照组的随机前瞻性临床试验。
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