Extrakorporale Stoßwellentherapie

Extracorporeal shock wave therapy (ESWT) has been established as a unique treatment option for soft tissue and bone pathologies. Typical indications include plantar fasciitis, tendinosis calcarea, and tennis elbow, as well as bone pathologies such as nonunions. Regarding the efficacy of ESWT in acute fractures, the literature is herein reviewed. Significant and effective acceleration of fracture and osteotomy healing as well as improvement of biomechanical bone properties by ESWT has been demonstrated in most of the relevant published animal studies. Thus, variable and noncomparable treatment parameters have been applied, and an optimized treatment protocol still must be established. Clinical data are limited to one prospective randomized trial, which demonstrated significant stimulation of healing of long bone fractures after ESWT was applied to the fracture site immediately after open reduction and internal fixation. Additional studies are required to corroborate the effectiveness of ESWT in acute fractures. Although the effectiveness of ESWT has been postulated in a myriad of trials investigating nonunions, published data are not sufficient to allow the recommendation of shock wave treatment for acute fractures also.