Evidence map›Paper›PMID 34997869›Full record

ArticleJournal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology2022

Addition of shock wave therapy to nail dynamization increases the chance of long-bone non-union healing.

Josef Stolberg-Stolberg, Thomas Fuchs, Moritz F Lodde, Steffen Roßlenbroich, Patric Garcia, Michael Raschke, Jens Everding

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In one paragraph

Article in Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Extracorporeal shockwave therapy in bone fractures: a systematic review.Archives of orthopaedic and trauma surgery · 2026
    Pooled it
  2. Review
  3. Review
  4. Review
  5. Clinical Results of Decortication with Bone Grafting Method versus Extracorporeal Shock Wave Treatment in Long-Bone Pseudoarthrosis.Medical science monitor : international medical journal of experimental and clinical research · 2023
    Article
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Josef Stolberg-StolbergDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building W1, 48149, Muenster, Germany.
Thomas FuchsDepartment of Trauma and Reconstructive Surgery, Vivantes Hospital Friedrichshain, Landsberger Allee 49, 10249, Berlin, Germany.
Moritz F LoddeDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building W1, 48149, Muenster, Germany.
Steffen RoßlenbroichDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building W1, 48149, Muenster, Germany.
Patric GarciaDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building W1, 48149, Muenster, Germany.
Michael RaschkeDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building W1, 48149, Muenster, Germany. Michael.Raschke@ukmuenster.de.
Jens EverdingDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building W1, 48149, Muenster, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLong-bone non-unions after intramedullary nailing can be treated by nail dynamization or focused high-energy extracorporal shock wave therapy (fESWT). The objective of this study was to assess the effect of the combination therapy of nail dynamization and fESWT on long-bone non-unions. MATERIALS AND

methods49 patients with long-bone non-unions (femur and tibia) after nailing were treated with nail dynamization (group D, n = 15), fESWT (group S, n = 17) or nail dynamization in addition to fESWT (group DS, n = 17). Patients were followed up for 6 months retrospectively. Furthermore, age, sex, Non-Union Scoring System (NUSS) score, time intervals from primary and last surgery until intervention and smoking status were analysed for their correlations to bone union.

resultsUnion rates were 60% for group D, 64.7% for group S and 88.2% for group DS, with a significant difference between group D and DS (p = 0.024). Successful treatment was correlated with high age (OR 1.131; 95% CI 1.009-1.268; p = 0.034), female gender (OR 0.009; 95% CI 0.000-0.89; p = 0.039), low NUSS score (OR 0.839; 95% CI 0.717-0.081; p = 0.028) and negative smoking status (OR 86.018; 95% CI 3.051-2425.038; p = 0.009).

conclusionsData from the present study indicate that the combination therapy of nail dynamization and fESWT leads to a higher union rate than dynamization or fESWT alone. LEVEL OF EVIDENCE: Level 3.

Indexed as

Extracorporeal Shockwave TherapyFemoral FracturesFracture Fixation, IntramedullaryFractures, UnunitedBone NailsFemaleFracture HealingHumansRetrospective StudiesTreatment OutcomeLong bonesNail dynamizationNon-unionShock wave

Identifiers

PMID34997869
PMCPMC8742797

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.