PMID- 35969158
OWN - NLM
STAT- MEDLINE
DCOM- 20240201
LR  - 20240206
IS  - 1532-5040 (Electronic)
IS  - 0959-3985 (Linking)
VI  - 40
IP  - 2
DP  - 2024 Feb
TI  - Callus formation and bone remodeling in a tibial nonunion after minimal invasive 
      percutaneous screw fixation followed by extracorporeal shockwave therapy 
      17-months after initial trauma - A case report.
PG  - 395-407
LID - 10.1080/09593985.2022.2112117 [doi]
AB  - INTRODUCTION: The treatment of tibial nonunion is challenging and treatment may 
      be conservative or surgical. Conservative strategies include functional braces 
      and weight bearing, or focused extracorporeal shockwave therapy (fESWT). CASE 
      DESCRIPTION: A 45-year-old male patient sustained spiral tibial shaft fractures 
      and was treated surgically within 24 hours after the initial accident with 
      intramedullary nails. The tibial fracture was later classified as nonunion after 
      11 months. Radiologic evaluation 17 months after the initial trauma demonstrated 
      clinical nonunion, and subsequently the patient was offered a conservative 
      approach with fESWT to facilitate an increase in callus formation. The handpiece 
      was fitted with a stand-off II (long), penetration depth of 15 mm. Three cycles 
      were administered in month 17, 19 and 20 after baseline. Each cycle consisted of 
      three treatments sessions spaced with 6-8 days apart, and consisted of 3000 to 
      4000 impulses each given at 0.25-0.84 mJ/mm(2). The number of impulses and the 
      power at the focus point varied according to the pain response. OUTCOMES: The 
      patient achieved union 23 months after fracture. A clinical important improvement 
      was observed with both Lower Extremity Functional Scale (LEFS) (18-point 
      difference) and Patient Specific Functional Scale (PSFS) (average: 4.7 points,) 
      The "worst pain last 24 hours" was reduced by 5 points. These values express 
      minimal clinically important difference (MCID) values in these functional 
      patient-reported outcome measures. CONCLUSION: This treatment strategy may be 
      viable in a broader setting, including private practice physiotherapy thereby 
      treating the patient in close proximity to the patient's everyday life.
FAU - Jorgensen, Jens Erik
AU  - Jorgensen JE
AUID- ORCID: 0000-0003-3467-6212
AD  - Sofiendal Aalborg Health Team, Aalborg, Denmark.
FAU - Larsen, Peter
AU  - Larsen P
AD  - Department of Occupational Therapy and Physiotherapy, Aalborg University 
      Hospital, Aalborg, Denmark.
AD  - Department of Orthopaedic Surgery, Aalborg University Hospital, Aalborg, Denmark.
FAU - Elsoe, Rasmus
AU  - Elsoe R
AD  - Department of Orthopaedic Surgery, Aalborg University Hospital, Aalborg, Denmark.
FAU - Molgaard, Carsten M
AU  - Molgaard CM
AD  - Department of Occupational Therapy and Physiotherapy, Aalborg University 
      Hospital, Aalborg, Denmark.
AD  - Department of Orthopaedic Surgery, Aalborg University Hospital, Aalborg, Denmark.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20220813
PL  - England
TA  - Physiother Theory Pract
JT  - Physiotherapy theory and practice
JID - 9015520
SB  - IM
MH  - Male
MH  - Humans
MH  - Middle Aged
MH  - Treatment Outcome
MH  - *Extracorporeal Shockwave Therapy
MH  - Bone Remodeling
MH  - Bone Screws
MH  - Pain
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Extracorporeal shock wave therapy
OT  - nonunion
OT  - physiotherapy
OT  - primary sector
EDAT- 2022/08/16 06:00
MHDA- 2024/02/01 06:43
CRDT- 2022/08/15 09:53
PHST- 2024/02/01 06:43 [medline]
PHST- 2022/08/16 06:00 [pubmed]
PHST- 2022/08/15 09:53 [entrez]
AID - 10.1080/09593985.2022.2112117 [doi]
PST - ppublish
SO  - Physiother Theory Pract. 2024 Feb;40(2):395-407. doi: 
      10.1080/09593985.2022.2112117. Epub 2022 Aug 13.