Shock Waves Heal Fractured Bones
Daniel Knowlton • Fri, Nov 6th, 2009
Copyright 2009 RRY Publications


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According to a new study published in the November 2009 issue of The Journal of Bone and Joint Surgery, shock-wave therapy is as effective as surgery in healing fractures which have resulted in nonunion. This treatment method could become a more economical and less painful option for patients.

The Study

Dr. Angelo Cacchio led the research with colleagues from the Division of Orthopaedic Surgery and the Department of Physical Medicine and Rehabilitation at San Salvatore Hospital in L’Aquila, Italy. The study, titled “Extracorporeal Shock-Wave Therapy Compared with Surgery for Hypertrophic Long-Bone Nonunions” followed 126 patients from 2001 to 2004 who suffered from fractures which resulted in nonunion. The research centered on the treatment of femur, tibia, ulna, and radius fractures.

Researchers randomly placed the patients into one of three groups. The first two groups of patients received shock-wave therapy constituting four treatments of 4000 impulses of shock waves with an energy flux density of 0.40 mJ/mm2 (Group 1) or 0.70 mJ/mm2 (Group 2). Group 3 patients received surgery for their fractures. According to the study, “at both twelve- and twenty-four months after treatment, there were no differences among the three groups.” Earlier in the healing process, at the six month mark, radiographic results showed that nonunions healed in 70% of Group 1 patients, 71% of Group 2 patients, and 73% of Group 3 patients.

Shock-wave therapy may also have the advantage of providing more immediate positive results. In the November 2 press release for the study, Dr. Cacchio explains,

When we examined patients and compared their outcomes at three and six months, initially those who received the shock-wave therapy actually felt better than those who had surgery. When we examined patients at 12 and 24 months, there were no significant differences in terms of healing. Scans of the bones proved non-invasive shock-wave therapy worked just as effectively as surgery.
How Does it Work?

Researchers believe that shock-wave therapy stimulates certain growth factors which encourage the bone tissue to regenerate. The treatment elicits a metabolic reaction similar to what occurs during the natural process of bone healing. Shock waves also help reduce pain so that patients feel better sooner than if they received surgical treatment.

Shock-wave therapy may be less painful for patients than surgery, but is it also easy on their wallets? Dr. Cacchio told OTW that

In Europe (and especially in Italy and Germany), shock-wave therapy is more economical than surgery, and above all, it carries less risk of adverse events. Much more will be done to make shock-wave therapy for nonunions even more economical.
In the U.S., physicians have used shock-wave therapy for years to dissolve kidney stones, and orthopedists have used shock waves to treat conditions such as jumper’s knee and tennis elbow. While using shock-wave therapy to treat bone fractures is still a relatively new procedure, studies such as this will hopefully encourage more research into the effectiveness of this treatment.

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