Radial extracorporeal shock wave promotes the treatment of non-union of femoral shaft fractures in children: a case report.

IF 1.6 4区医学 Q2 SURGERY

Frontiers in Surgery Pub Date : 2025-09-22 eCollection Date: 2025-01-01 DOI:10.3389/fsurg.2025.1667385

He Shang, Tao Ma, Xueqi Liu, Tianxiang Yang, Yongzhu Luo, Jun Li, Jinpeng Liang, Desheng Chen

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Abstract

Background: Despite the minimally invasive benefits of flexible intramedullary nails (FIN) for pediatric femoral shaft fractures, nonunion may occur. Traditional surgical revisions carry high trauma and risk, while radial extracorporeal shockwave therapy (rESWT) has potential for promoting bone healing but lacks sufficient evidence in such pediatric cases.

Methods: A 4-year-old male with left femoral shaft fracture (AO/OTA 32A2) and FDA-defined nonunion 9 months after FIN fixation received rESWT. Using Gymna ShockMaster 300 (Uniphy), parameters were 6-8 Hz, 2.0-3.0 bar, 1,000-1,500 pulses/week for 3-4 weeks (covering fracture and 2 cm around). Treatment included pre-procedural screening, professional operation, gamified communication, and concurrent rehabilitation.

Results: Post-rESWT, fracture lines blurred then disappeared, with clinical healing achieved and no complications. At 3-month follow-up, intramedullary nail was removed; the patient had 80% weight-bearing capacity, independent walking (mild gait asymmetry), and full weight-bearing recovery later.

Conclusion: rESWT effectively reverses post-FIN nonunion in pediatric femoral shaft fractures, with advantages of non-invasiveness, safety, and good compliance. It is a feasible alternative for surgery-limited cases, though long-term efficacy needs large-scale validation.

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桡骨体外冲击波促进儿童股骨干骨折不愈合的治疗1例。

背景：尽管柔性髓内钉（FIN）治疗小儿股骨干骨折具有微创优势，但仍可能发生骨不连。传统的手术修复具有较高的创伤和风险，而桡骨体外冲击波治疗（rESWT）具有促进骨愈合的潜力，但在此类儿科病例中缺乏足够的证据。方法：一名4岁男性，左股骨干骨折（AO/OTA 32A2），经fda定义在FIN固定9个月后骨不连接受rESWT治疗。使用Gymna ShockMaster 300 (Uniphy)，参数为6- 8hz， 2.0-3.0 bar， 1000 - 1500脉冲/周，持续3-4周（覆盖骨折及周围2cm）。治疗包括术前筛查、专业操作、游戏化沟通和同步康复。结果：reswt术后骨折线模糊后消失，临床愈合，无并发症。随访3个月，取出髓内钉；患者负重能力80%，独立行走（轻度步态不对称），后完全恢复负重。结论：rESWT可有效逆转小儿股骨干骨折fin后骨不连，具有无创、安全、依从性好等优点。对于手术受限的病例，这是一种可行的替代方案，尽管长期疗效需要大规模的验证。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers in Surgery Medicine-Surgery

CiteScore

1.90

自引率

11.10%

发文量

1872

审稿时长

12 weeks

期刊介绍： Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles. Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery. Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact. The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.