ArticleJournal of clinical medicine2022
Extracorporeal Shockwave Therapy in the Treatment of Nonunion in Long Bones: A Systematic Review and Meta-Analysis.
Article in Journal of clinical medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
What it found
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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.
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.
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Who cites it
14 citing papers in PubMed, 16 citations in OpenAlex.
- Focused extracorporeal shock wave therapy as a salvage option for humeral shaft delayed union and non-union with implant loosening or fixation-related concerns: a report of three cases.JSES reviews, reports, and techniques · 2026Article
- [Shock waves as a preventive impulse : New approaches to reducing surgical and postoperative complications, including tissue regeneration].Orthopadie (Heidelberg, Germany) · 2026Review
- Extracorporeal Shockwave Therapy for the Treatment of Ulnar Shaft Fracture Delayed Union Following Open Reduction and Internal Fixation: A Case Report and Literature Review.Journal of orthopaedic case reports · 2026Article
- Extracorporeal shockwave therapy for long bone nonunion: additional considerations on prognostic factors.International journal of surgery (London, England) · 2026Article
- Focused shock wave therapy (ESWT) and electromagnetic transduction therapy (EMTT) may improve post-operative bone healing in selective foot and ankle surgeries: a case-control pilot study.Journal of orthopaedic surgery and research · 2025Article
- Article
- Radial extracorporeal shock wave promotes the treatment of non-union of femoral shaft fractures in children: a case report.Frontiers in surgery · 2025Article
- State of the Nonunion: A review of the latest literature.Orthopedic reviews · 2025Article
- Highly-Cited Papers on Fracture Non-union - A Bibliometric Analysis of the Global Literature (1990-2023).Indian journal of orthopaedics · 2024Review
- Proximal tibial replacement with megaprosthesis in the setting of proximal tibial nonunion: A case report.Trauma case reports · 2024Article
- Review
- No dose response effect in shockwave therapy applied to bone conditions: a systematic review, meta-analysis and meta-regression.Journal of orthopaedics · 2024Review
- Treatment of delayed union of the forearm with extracorporeal shockwave therapy: a case report and literature review.Frontiers in endocrinology · 2023Review
- Treatment of Femoral Shaft Pseudarthrosis, Case Series and Medico-Legal Implications.Journal of clinical medicine · 2022Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Nonunion is one of the most challenging problems in the field of orthopedics. The aim of this study was to perform a systematic review of the literature to evaluate the effectiveness of extracorporeal shockwave therapy (ESWT) in the treatment of nonunion in long bones. Methods: We conducted a search of three databases (PubMed, Scopus, and Web of Science) and found 646 total publications, of which 23 met our inclusion criteria. Results: Out of 1200 total long bone nonunions, 876 (73%) healed after being treated with ESWT. Hypertrophic cases achieved 3-fold higher healing rates when compared to oligotrophic or atrophic cases (p = 0.003). Metatarsal bones were the most receptive to ESWT, achieving a healing rate of 90%, followed by tibiae (75.54%), femurs (66.9%) and humeri (63.9%). Short periods between injury and treatment lead to higher healing rates (p < 0.02). Conversely, 6 months of follow-up after the treatment appears to be too brief to evaluate the full healing potential of the treatment; several studies showed that healing rates continued to increase at follow-ups beyond 6 months after the last ESWT treatment (p < 0.01). Conclusions: ESWT is a promising approach for treating nonunions. At present, a wide range of treatment protocols are used, and more research is needed to determine which protocols are the most effective.
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Registered trials
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.