Journal ArticleDOI
Extracorporeal shock wave treatment of non- or delayed union of proximal metatarsal fractures.
Richard G. Alvarez,Brandon Cincere,Chandra Channappa,Richard Langerman,Robert Schulte,Juha I. Jaakkola,Keith Melancon,Michael J. Shereff,G. Lee Cross +8 more
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TLDR
High-energy ESWT appears to be effective and safe in patients for treatment of nonunion or a delayed healing of a proximal metatarsal, and in fifth meetingatarsal fractures in Zone 2.Abstract:
Background:Nonunion or delayed union of fractures in the proximal aspect of metatarsals 1 to 4 and Zone 2 of the fifth metatarsal were treated by high energy extracorporeal shock wave treatment (ESWT) to study the safety and efficacy of this method of treatment in a FDA study of the Ossatron device.Materials and Methods:In a prospective single-arm, multi-center study, 34 fractures were treated in 32 patients (two subjects had two independent fractures) with ESWT. All fractures were at least 10 (range, 10 to 833) weeks after injury, with a median of 23 weeks. ESWT application was conducted using a protocol totaling 2,000 shocks for a total energy application of approximately 0.22 to 0.51 mJ/mm2 per treatment. The mean ESWT application time for each of the treatments was 24.6 ± 16.6 minutes, and anesthesia time averaged 27.1 ± 10.4 minutes. All subjects were followed for 1 year after treatment at intervals of 12 weeks, 6, 9, and 12 months.Results:The overall success rate at the 12-week visit was 71% with lo...read more
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Journal ArticleDOI
Extracorporeal Shock Wave Therapy in Musculoskeletal Disorders: A Review
TL;DR: It is feasible that shock waves could be used to treat various orthopaedic pathologies, removing the need for surgery, and suitable translational studies need to be performed before ESWT can become a valid alternative to surgery.
Journal ArticleDOI
Treatment and return to sport following a Jones fracture of the fifth metatarsal: a systematic review
TL;DR: Although supported by mostly level 4 evidence, intra-medullary screw fixation is more likely to lead to successful union of all types of Jones fractures compared to non-operative treatments.
C linical Application of Extracorporeal Shock Wave Therapy in Musculoskeletal Disorders: A Review
TL;DR: Extracorporeal shock wave therapy (ESWT) has become the treatment of choice for many orthopaedic disorders such as plantar fasciitis, lateral epicondylitis of the elbow, calcific tendinopathy of the shoulder and nonunion of long bone fractures as mentioned in this paper.
Journal ArticleDOI
Low-intensity shock wave therapy and its application to erectile dysfunction.
TL;DR: Low-energy shock wave therapy could be a novel modality for treating ED, and particularly PDE5I non-responders with organic ED, in the near future, however, further extensive evidence-based basic and clinical studies are needed.
Journal ArticleDOI
Fifth Metatarsal Fractures in the Athlete: Evidence for Management
TL;DR: In the chronic setting, good results have been shown with intramedullary screw fixation, surgical debridement and bone grafting alone, and tension band wiring, and shock wave therapy and pulsed electromagnetic fields may have a place in chronic and acute injury.
References
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Book
Surgery of the Foot and Ankle
TL;DR: General consideration principles of examination imaging conservative treatment peripheral anaesthesia, the forefoot lesser toe deformities, and the sesamoids and accessory bones of the foot are considered.
Journal ArticleDOI
The Jones fracture revisited.
TL;DR: Twenty-two patients with twenty-three fractures of the proximal part of the diaphysis of the fifth metatarsal, an injury originally described by Jones, are reported, and intramedullary screw fixation of the fracture is advised.
Journal ArticleDOI
Extracorporeal shock waves promote healing of collagenase-induced Achilles tendinitis and increase TGF-beta1 and IGF-I expression.
Yeung-Jen Chen,Ching-Jen Wang,Kuender D. Yang,Yur-Ren Kuo,Hui-Chen Huang,Yu-Ting Huang,Yi-Chih Sun,Feng-Sheng Wang +7 more
TL;DR: It is reported that an optimal ESW treatment promoted healing of Achilles tendintis by inducing TGF‐β1 and IGF‐I and played important roles in mediating ESW‐stimulated cell proliferation and tissue regeneration of tendon.
Journal ArticleDOI
Extracorporeal shock wave therapy of nonunion or delayed osseous union
W. Schaden,A. Fischer,A. Sailler +2 more
TL;DR: The application of extracorporeal shock wave therapy should be the first choice of treatment for patients with nonunions and delayed bone fracture healing and resulted in bony consolidation with a simultaneous decrease in symptoms.
Journal ArticleDOI
The Intraosseous Blood Supply of the Fifth Metatarsal: Implications for Proximal Fracture Healing
TL;DR: The intraosseous vascular anatomy of the fifth metatarsal, and the clinical implications for basilar fracture healing, suggests that a relative lack of blood supply following a proximal diaphyseal fracture may contribute to delayed union and nonunion.