体外冲击波治疗与手术治疗骨折延迟愈合临床疗效对比分析

目的 对比体外冲击波治疗（ESWT）与手术治疗骨折延迟愈合的临床治疗效果。方法 将30例在2017年1月至2018年1月于我院就诊且被诊断为骨折延迟愈合的患者随机分为手术治疗组和冲击波治疗组,每组各15例患者。手术治疗组行手术治疗,每月定期复查X线,冲击波治疗组采用体外冲击波治疗仪治疗,治疗期间每疗程治疗结束后复查X线片,通过观察治疗前与治疗后第1、第2、第3疗程的骨折处X线骨痂生长情况,对两组患者的骨痂形成情况进行评分,通过骨痂形成情况评分的高低、骨折愈合时间的长短和骨折愈合标准评价及治疗费用的高低,以此来探讨ESWT治疗骨折延迟愈合的临床疗效。结果 治疗后至少随访18个月,阅复查X线片示,两组患者的骨痂X线评分均高于治疗前。冲击波治疗组13例患者成功愈合,1例未完全愈合,骨折愈合时间平均为8.267个月,1例至随访结束骨折处未出现放射学愈合迹象。手术治疗组14例患者成功愈合,骨折愈合时间平均为8.714个月,1例至随访结束骨折处未出现放射学愈合迹象。两组患者至随访结束均未见明显血管神经损伤或内固定断裂等并发症发生。结论 ESWT对骨折延迟愈合有显著的临床疗效,且因其具有非侵入性、方法简单、安全有效、并发症率较低且费用相对较低等优点。

Comparative analysis of clinical effect of extracorporeal shock wave therapy and surgery in treatment of delayed union of fractures

Objective To compare the clinical effect between extracorporeal shock wave therapy（ESWT） and surgery in treatment of delayed union of fractures. Methods Thirty patients who visited our hospital from Jan. 2017 to Jan. 2018 with delayed union of fracture diagnoses were randomly divided into surgical group and ESWT group. Each group has 15 patients. In the clinical trial, the surgical group received surgical treatment, and X-rays were re-examined regularly every month. By comparison, the ESWT group was treated with extracorporeal shock wave. Besides, X-rays were re-examined after each course of treatment. X-ray callus growth at the fracture site was observed before treatment and at the 1^st, 2^nd and 3^rd courses of treatment. The formation of callus was scored. The clinical efficacy of extracorporeal shock wave therapy for delayed fracture healing was explored by measuring callus status, the period of healing time for fractured bones, the evaluation of fracture healing criteria, and treatment costs. Results Patients were followed up after at least 18 months of treatment. The X-ray scores of callus in both groups were higher than those before treatment. In the ESWT group, 13 patients totally recovered, while 1 partly recovered. Moreover, the average time of fracture healing was 8.267 months, and 1 had no radiological healing sign at the fracture site until the end of follow-up. In the surgical group, 14 patients totally recovered, using 8.714 months on average. One patient didn't show radiological signs of union at the fracture site until the end of follow-up. Additionally, there were no significant complications （such as vascular nerve injury, internal fixation） fracture observed in either group bythe end of follow-up. Conclusion Extracorporeal shock wave therapy has significant clinical efficacy in the treatment of delayed union of fractures, and it is worthy of clinical application because of itis non-invasive, simple, safe and effective, without complications and relatively low cost.