Efficacy of radial shockwave therapy for promoting healing of delayed of forearm fractures in children with ultrasonic guidance
10.3760/cma.j.cn121113-20201106-00638
- VernacularTitle:超声引导下放散状体外冲击波治疗儿童前臂骨折延迟愈合
- Author:
Shan WANG
1
;
Wei HE
;
Fangfang DUAN
;
Anyi GUO
;
Longhao ZHANG
;
Yajun LIU
Author Information
1. 北京积水潭医院骨科冲击波治疗中心，北京 100035
- Keywords:
Child;
Forearm;
Fractures, bone;
Extracorporeal shockwave therapy;
Fractures, ununited
- From:
Chinese Journal of Orthopaedics
2022;42(2):103-110
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical effect of radial extracorporeal shockwave therapy on delayed union of forearm fractures in children with ultrasonic guidance.Methods:A retrospective analysis of information on 18 children with delayed forearm fracture union who received ultrasonic guided extracorporeal shockwave therapy from February 2018 to June 2019 was conducted. Among them, there were 14 males and 4 females; Age: 9.44±3.75 years (range, 3-15 years); All the children were closed forearm fractures, including 13 cases of ulna and 5 cases of radius. Initial fixation methods: intramedullary nails fixation in 8 cases, Kirschner wire fixation in 4 cases, steel plate fixation in 2 cases, external fixation in 2 cases, conservative treatment in 2 cases; The classification of fracture nonunion were: 14 cases of hypertrophy, 4 cases of atrophy; The course of disease was 4.0 (3.0, 6.0) months. The front and lateral X-ray films of the affected side forearm were taken before treatment, 3 months and 6 months after treatment. The scores of callus condition were performed using Lane-Sandhu X-ray scoring standard and Fernandez-Esteve X-ray evaluation standard of callus grade.Results:All children completed treatment and were followed up for 6 months. The bone healing standard was the disappearance of the fracture line shown by anterior and lateral X-ray films. Within 6 months after treatment, 11 patients got bone union. The healing rate was 61.11% (11/18). The average of Lane-Sandhu X-ray scores before treatment, 3 months and 6 months after treatment were 3.0 (1.0, 4.0), 6.0 (4.0, 8.0) and 10.0 (5.0, 12.0), respectively, there were statistically significant differences in pairwise comparisons at each time point. And the average scores of Fernandez-Esteve X-ray evaluation standard for callus grade were 1.0 (1.0, 2.0), 3.0 (2.0, 4.0), and 4.0 (3.0, 4.0), respectively, there were statistically significant differences from 3 months and 6 months after treatment to preoperative group, while there was no statistically significant difference between 3 months and 6 months after treatment. The mixed effects model analysis results showed that only the Lane Sandhu X-ray score and Fernandez Esteve X-ray standard score of callus grade at different follow-up time points were significantly different. There was no statistically significant difference in age, gender, number of shockwave treatments and interval time from the first treatment after the initial fixation.Conclusion:The radial extracorporeal shockwave therapy can effectively treat the delayed healing of forearm fractures in children; the X-ray score has been significantly improved. The treatment is highly accepted by children and their parents, and can be used as one of the methods to treat delayed healing of fractures in children in the future.
