高能体外震波(ESWT)治疗长骨骨不连

目的] 探讨使用高能体外震波（ESWT）治疗长骨骨不连的效果。方法] 本组20例长骨骨折切开复位内固定或石膏外固定治疗后骨不连，2例萎缩型，18例增生型。采用C臂机结合Ossatron ESWT治疗仪，分别取尺、桡骨24kv，肱骨26kv，胫骨、股骨28kv的震波强度，尺、桡骨1500次，肱骨3000次，股骨及胫骨6000次。结果] 平均随访15．2个月。8例3个月后骨愈合，6例4个月后骨愈合，3例5个月后骨愈合，1例6个月后仍未愈合，再次行ESWT治疗后4个月愈合，2例6个月后未愈合，行切开复位内固定＋植骨后愈合。平均愈合时间为3．9个月，愈合率达90％。结论] ESWT可以做为治疗长骨骨不连及骨延迟愈合的有效治疗方法。

Extracoporeal shock wave therapy in nonunion or delayed union of long bones

Objective]To explore the effect of extracoporeal shock wave therapy (ESWT) in nonunion of long bones. Methods]Twenty cases of long bone fractures received open reduction and internal fixation or plaster external fixation, in which 2 cases were oligotrophic and 18 cases were hypertrophic. All cases were found nonunion and so were treated with Ossatron ESWT machine combined with C-arm X ray machine, and different shock wave densities were used as following : 24 kv and 1 500 times for radius and ulna; 26 kv and 3 000 times for humerus ; 28 kv and 6000 times for femur and tibia.Result]An average 15.2 months' follow up was carried out after ESWT therapy. Seventeen cases resulted in bone healing 3 to 5 months after ESWT. Bone healing was not observed in one case 6 months after the first ESWT, the second ESWT was carried out for 4 months until the final bone union. Another 2 cases remained nonunion 6 months after ESWT and open reduction and internal fixation combined with autografting were carried out to achieve final bone healing. The average healing period of all cases was 3.8 months.Conclusion]ESWT is an effective method to treat nonunion or delayed osseous union of long bones.