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                                            • Extracorporeal shock wave therapy (ESWT) of non-union or delayed union of fractures

                                            Extracorporeal shock wave therapy (ESWT) of non-union or delayed union of fractures

                                            02_high_tech_med
                                            Research area: High tech medicine

                                            Responsible for the project: Marisa Warmuth
                                            Project team: Marisa Warmuth, Ines Schumacher
                                            Duration: July 2012 - Aug 2012
                                            Publication: Decision Support Document No. 62: https://eprints.aihta.at/975

                                            Suggested by: KAGES
                                            Language: German

                                            Background:
                                            Extracorporeal shock wave therapy (ESWT) was introduced for the first time in 1980 in the field of urology for non-invasive disintegration of concrements of the kidney and urinary tract. Since the early 1990s the spectrum of indications for ESWT has been continuously evolving. It has been employed for the treatment of various diseases in the field of orthopaedics (e.g.: tendinopathies, fractures), dermatology (e.g.: chronic wounds, fibromatoses), cardiology (coronary heart disease), etc..
                                            In ESWT an acoustic wave with a characteristic progress in the course of time is generated, which follows one of three principles: the electrohydraulic, electromagnetic or piezoelectric principle. It is assumed that ESWT leads to improvement in pain and accelerates the healing process.

                                            Aims of project:
                                            The project aims at summarising the evidence of the efficacy and safety of ESWT in non-union or delayed union of fractures

                                            Research objectives:
                                            Is ESWT for the treatment of non-union or delayed union of fractures more effective and safe than standard treatment in terms of function, pain, quality of life, union rate, time to fracture union and morbidity?

                                            Methods:
                                            • Systematic literature search in databases (Cochrane, Embase, Medline, CRD) and web sites
                                            • Unsystematic hand search
                                            • Contacting of manufacturers

                                            PICO-Fragestellung:
                                             

                                            Population

                                            Adults  ?18 yrs with delayed union or non-union of fractures
                                            Intervention Extracorporeal shock-wave therapy (ESWT)
                                            Control Standard-of-care treatment, such as
                                            -          non-surgical treatment like plaster cast immobilisation
                                            -          surgical treatment like external or internal fixation (e.g. intramedullary nailing) 
                                            Outcomes  
                                            Efficacy Improved function
                                            Improved pain
                                            Quality of life
                                            Union rate
                                            Time to fracture union
                                            Safety Morbidity
                                            Study design  
                                            Efficacy Prospective controlled clinical trials
                                            Safety Prospective clinical trials


                                            Time schedule/ milestones (in months):
                                            • July 2012: project protocol, unsystematic/ systematic literature search, literature selection, drafting of report
                                            • August 2012: drafting of report, internal/ external review, publication

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