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FRIDAY, Nov. 6 (HealthDay News) -- Extracorporeal shock-wave therapy may be as effective as surgery in promoting the union of long-bone factures over the long term and may provide better short-term clinical outcomes than surgery, according to a study in the November Journal of Joint & Bone Surgery.
Angelo Cacchio, M.D., of San Salvatore Hospital of L'Aquila in Rome, and colleagues randomized patients with long-bone nonunion fractures to receive either shock-wave therapy using the Dornier Epos Ultra lithotripter (group one) or the Modulith SLK (group two), or surgical nail or plate fixation (group three). Participants included in the three groups were similar in terms of demographics, duration of nonunion fractures and duration of follow-up. The outcomes included radiographic findings and clinical results (Disabilities of the Arm, Shoulder and Hand [DASH] scores and Lower Extremity Functional Scale [LEFS]) at three, six, 12, and 24 months post-treatment.
At six months, the researchers found that the proportion of patients who showed healing in radiographic imaging was similar for the three groups: 70 percent in group one, 71 percent in group two, and 73 percent in group three. At three and six months, DASH and LEFS scores were better in the shock-wave groups than in the surgical group. At 12 and 24 months follow-up, the only significant difference among the groups was for DASH scores.
"Extracorporeal shock-wave therapy is as effective as surgery in stimulating union of long-bone hypertrophic nonunions and yields better short-term clinical outcomes," the authors conclude.
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