Yang Qing, Xu Feng, Zhu Jing, Sun Li, Qu Qingming, Liu Su, Wang Siye
Department of Rehabilitation Medicine, Affiliated Hospital of Nantong University Nantong 226001, Jiangsu, China.
Graduate School of Dalian Medical University Dalian 116000, Liaoning, China.
Am J Transl Res. 2025 Mar 15;17(3):1860-1871. doi: 10.62347/WWFD7121. eCollection 2025.
To investigate the therapeutic efficacy of extracorporeal shock wave therapy (ESWT) combined with kinesitherapy (KT) for the treatment of delayed union of tibia and fibula fractures.
A total of 68 patients with delayed healing of tibiofibular fractures were enrolled. These patients were divided into three groups: control, ESWT, and ESWT+KT. All patients underwent standard surgical treatment following the fracture. Patients in the ESWT group received shockwave therapy twice a week for 4 months, while those in the ESWT+KT group received additional exercise therapy twice a week over the same duration. The control group did not receive any specific intervention during this period. The pain levels of patients in all three groups were assessed using the Numerical Rating Scale (NRS) before and after treatment. Bone repair and callus formation were evaluated using the Lane-Sandhu and Fernandez-Esteve X-ray grading scales before and after treatment. Additionally, walking ability was assessed using the Functional Ambulation Classification (FAC), Hoffer walking ability grade, and Holden walking ability grade before and after treatment.
No significant differences were observed in patient baseline characteristics across the three groups ( > 0.05), indicating comparability among groups. Post-treatment, improvements were noted in the NRS, Lane-Sandhu X-ray scale, Fernandez-Esteve X-ray scale, FAC level, Hoffer grade, and Holden grade in all three groups compared to their respective pre-treatment values ( < 0.05). Notably, the Lane-Sandhu X-ray scale, FAC level, Hoffer grade, and Holden grade showed significant improvements in the ESWT+KT group after treatment compared to the control group ( < 0.05). Additionally, the ESWT group demonstrated significant improvements in FAC level and Holden grade compared to the control group after treatment ( < 0.05).
ESWT can enhance the walking function in patients with delayed union of tibia and fibula fractures. ESWT combined with KT demonstrates superior efficacy compared to monotherapy, as it not only improves walking function but also promotes bone healing.
探讨体外冲击波疗法（ESWT）联合运动疗法（KT）治疗胫腓骨骨折延迟愈合的疗效。
共纳入68例胫腓骨骨折延迟愈合患者。这些患者被分为三组：对照组、ESWT组和ESWT+KT组。所有患者骨折后均接受标准手术治疗。ESWT组患者每周接受两次冲击波治疗，持续4个月，而ESWT+KT组患者在相同时间段内每周额外接受两次运动治疗。在此期间，对照组未接受任何特殊干预。使用数字评分量表（NRS）评估三组患者治疗前后的疼痛程度。使用Lane-Sandhu和Fernandez-Esteve X线分级量表评估治疗前后的骨修复和骨痂形成情况。此外，使用功能步行分类（FAC）、霍弗步行能力分级和霍尔登步行能力分级评估治疗前后的步行能力。
三组患者的基线特征无显著差异（>0.05），表明组间具有可比性。治疗后，三组患者的NRS、Lane-Sandhu X线量表、Fernandez-Esteve X线量表、FAC水平、霍弗分级和霍尔登分级与各自治疗前的值相比均有改善（<0.05）。值得注意的是，治疗后ESWT+KT组的Lane-Sandhu X线量表、FAC水平、霍弗分级和霍尔登分级与对照组相比有显著改善（<0.05）。此外，治疗后ESWT组的FAC水平和霍尔登分级与对照组相比有显著改善（<0.05）。
ESWT可增强胫腓骨骨折延迟愈合患者的步行功能。ESWT联合KT与单一疗法相比疗效更佳，因为它不仅能改善步行功能，还能促进骨愈合。
