Treatment of delayed union of the forearm with extracorporeal shockwave therapy: a case report and literature review

Compared to other long bones, forearm fractures are particularly challenging due to the high rate of complications. These include malunion, delayed/nonunion, wrist and elbow movement reduction, and pain. Surgical procedure is considered the gold standard for managing delayed union and nonunion of th...

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Bibliographic Details
Published in:	Frontiers in endocrinology (Lausanne) Vol. 14; p. 1286480
Main Authors:	Ryskalin, Larisa, Fulceri, Federica, Morucci, Gabriele, Dell'Agli, Stefania, Soldani, Paola, Gesi, Marco
Format:	Journal Article
Language:	English
Published:	Switzerland Frontiers Media S.A 15-11-2023
Subjects:	bone healing Bone Regeneration delayed union fracture Endocrinology Extracorporeal Shockwave Therapy Forearm Forearm Injuries - therapy Fracture Healing Fractures, Bone - therapy Fractures, Ununited - surgery Humans long bone fracture long bone fracture forearm bone healing delayed union fracture extracorporeal shockwave therapy
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Summary:	Compared to other long bones, forearm fractures are particularly challenging due to the high rate of complications. These include malunion, delayed/nonunion, wrist and elbow movement reduction, and pain. Surgical procedure is considered the gold standard for managing delayed union and nonunion of the long bones. However, in the last decades, extracorporeal shockwave therapy (ESWT) has emerged as an effective and less invasive approach to enhance bone regeneration and fracture healing, avoiding major complications of surgical procedures. In contrast to the broad literature reporting good clinical results of ESWT in the treatment of nonunions, there is currently limited evidence regarding the clinical application of shock waves on long bone delayed fractures, particularly those of the forearm. In the present paper, we report a case of delayed bone healing of the diaphyseal region of the ulna treated with focused ESWT. The successful case experienced bone healing at the fracture site in less than 3 months after initial ESWT treatment. Acknowledging the limitation of reporting a case report, however, the remarkable clinical results and the absence of side effects contribute valuable information in support of the use of ESWT as an effective alternative to standard surgery for forearm fractures.
Bibliography:	ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Review-3 content type line 23 ObjectType-Feature-5 ObjectType-Article-4 ObjectType-Report-1 Edited by: Jonathan H. Tobias, University of Bristol, United Kingdom These authors have contributed equally to this work and share first authorship Reviewed by: Fiona Limanaqi, University of Milan, Italy; Stefano Ratti, University of Bologna, Italy
ISSN:	1664-2392 1664-2392
DOI:	10.3389/fendo.2023.1286480