{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T23:18:11Z","timestamp":1784675891163,"version":"3.55.0"},"reference-count":28,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Handchir Mikrochir Plast Chir"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>Die fokussierte hochenergetische extrakorporale Sto\u00dfwellentherapie (ESWT)\n                        f\u00f6rdert die Knochenheilung durch Neo-Angiogenese, Pooling von Stammzellen\n                        und Aktivierung von Osteozyten. In dieser Studie wurde untersucht, ob eine\n                        zus\u00e4tzliche intraoperative ESWT die Heilungsrate von\n                        Skaphoidrekonstruktionen mit nicht-vaskularisierten Knochentransplantaten\n                        bei Pseudarthrose verbessert oder beschleunigt.<\/jats:p>\n                  <jats:p>In dieser randomisierte kontrollierten Studie wurden 93 Patienten\n                        eingeschlossen, die sich einer Kahnbeinrekonstruktion mit einem\n                        nicht-vaskularisierten Knochentransplantat (Radiusspongiosa, Beckenspongiosa\n                        oder Beckenkammspan) unterzogen. Die Patienten wurden in 2 Gruppen\n                        eingeteilt: eine Interventionsgruppe, die zus\u00e4tzlich zur Rekonstruktion eine\n                        intraoperative ESWT erhielt, und eine Kontrollgruppe mit alleiniger\n                        Rekonstruktion. Die Heilungsraten sowie der Anteil der prozentualen\n                        Durchbauung zwischen Skaphoid und Knochentransplantat wurden 12, 18 und 24\n                        Wochen postoperativ klinisch und radiologisch evaluiert und verglichen.<\/jats:p>\n                  <jats:p>Nach 24 Wochen waren in der Interventionsgruppe 80% der Kahnbeine (37 von 46)\n                        und in der Kontrollgruppe 66% der Kahnbeine (31 von 47) geheilt. Die\n                        Heilungsraten im proximalen Kahnbeindrittel lagen in der Interventionsgruppe\n                        bei 77% und in der Kontrollgruppe bei 76%, im mittleren Drittel bei 82% und\n                        57%, alle Pseudarthrosen des distalen Drittels wurden zur Ausheilung\n                        gebracht. Die prozentuale Durchbauung des Kahnbeins distal des Transplantats\n                        war nach 12 Wochen in der Interventionsgruppe signifikant h\u00f6her (87%\n                        gegen\u00fcber 80%), nicht aber proximal am Transplantat.<\/jats:p>\n                  <jats:p>Die einmalige intraoperative ESWT verbessert die Heilungsrate der\n                        Skaphoidrekonstruktion mit einem nicht-vaskul\u00e4ren Knochentransplantat und\n                        beschleunigt die Knochenheilung w\u00e4hrend der ersten 12 Wochen\n                        postoperativ.<\/jats:p>","DOI":"10.1055\/a-2701-8768","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T22:30:30Z","timestamp":1761172230000},"page":"344-355","source":"Crossref","is-referenced-by-count":2,"title":["Intraoperative Shock-Wave Application in Scaphoid\n                    Reconstruction with Non-Vascularised Bone Grafts: A Randomised Controlled\n                    Trial"],"prefix":"10.1055","volume":"57","author":[{"given":"Marion","family":"M\u00fchldorfer-Fodor","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Handchirurgie, Rh\u00f6n Klinikum Campus Bad Neustadt, Bad\n                    Neustadt, Germany"},{"name":"Zentrum f\u00fcr Hand- und Rekonstruktive Handchirurgie, Roland-Klinik\n                    Bremen, Bremen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Wagner","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Diagnostische Radiologie, Rh\u00f6n Klinikum Campus Bad Neustadt,\n                    Bad Neustadt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanja","family":"Kottmann","sequence":"additional","affiliation":[{"name":"CRO Kottmann, Clinical Research Organisation (CRO), Hamm,\n                    Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg","family":"van Schoonhoven","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Handchirurgie, Rh\u00f6n Klinikum Campus Bad Neustadt, Bad\n                    Neustadt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl-Josef","family":"Prommersberger","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Handchirurgie, Rh\u00f6n Klinikum Campus Bad Neustadt, Bad\n                    Neustadt, Germany"},{"name":"Klinik f\u00fcr Elektive Handchirurgie, St. Josef Krankenhaus Schweinfurt,\n                    Schweinfurt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakob Richard","family":"Schnegg","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Handchirurgie, Rh\u00f6n Klinikum Campus Bad Neustadt, Bad\n                    Neustadt, Germany"},{"name":"Hand- und Plastische Chirurgie, Kantonsspital Winterthur, Winterthur,\n                    Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,10,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"322","DOI":"10.1055\/s-0041-1735349","article-title":"Predictors of Failure for Vascularized and Nonvascularized Bone Grafting of\n                    Scaphoid Nonunions: A Systematic Review","volume":"14","author":"S K Rancy","year":"2022","journal-title":"J Hand Microsurg"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1016\/j.hcl.2019.03.005","article-title":"Does Anyone Need a Vascularized Graft?","volume":"35","author":"S K Rancy","year":"2019","journal-title":"Hand Clin"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"101759","DOI":"10.1016\/j.hansur.2024.101759","article-title":"Graft choice for managing scaphoid non-union: umbrella review","volume":"43","author":"A Baamir","year":"2024","journal-title":"Hand Surg Rehabil"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1177\/1753193410375776","article-title":"Gadolinium-enhanced preoperative MRI scans as a prognostic parameter in scaphoid\n                    nonunion","volume":"36","author":"K Megerle","year":"2011","journal-title":"J Hand Surg Eur Vol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1177\/1753193417732003","article-title":"Success of scaphoid nonunion surgery is independent of proximal pole\n                    vascularity","volume":"43","author":"S K Rancy","year":"2018","journal-title":"J Hand Surg Eur Vol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1007\/s00402-022-04480-8","article-title":"Perfusion of the proximal scaphoid pole: correlation between preoperative ge-MRI\n                    and intraoperative findings","volume":"143","author":"V F Struckmann","year":"2022","journal-title":"Arch Orthop Trauma Surg"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"350","DOI":"10.1055\/a-2406-5858","article-title":"Hochenergetische, fokussierte extrakorporale Sto\u00dfwellentherapie (ESWT) bei\n                    Knochenheilungsst\u00f6rungen von Unterarm und Hand","volume":"56","author":"E-K Liedl","year":"2024","journal-title":"Handchir Mikrochir Plast Chir"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1188297","DOI":"10.3389\/fendo.2023.1188297","article-title":"The effects and underlying mechanism of extracorporeal shockwave therapy on\n                    fracture healing","volume":"14","author":"F Lv","year":"2023","journal-title":"Front Endocrinol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1306","DOI":"10.1016\/j.ultrasmedbio.2010.05.004","article-title":"Extracorporeal Shockwaves Versus Surgery in the Treatment of Pseudoarthrosis of\n                    the Carpal Scaphoid","volume":"36","author":"A Notarnicola","year":"2010","journal-title":"Ultrasound Med Biol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1055\/a-0914-2963","article-title":"Hochenergetische extrakorporale Sto\u00dfwellentherapie bei verz\u00f6gerter Heilung von\n                    Kahnbeinfrakturen und Pseudarthrosen: eine retrospektive Analyse der\n                    Konsolidierungsrate und therapieentscheidungsrelevanter Faktoren","volume":"51","author":"T Fallnhauser","year":"2019","journal-title":"Handchir Mikrochir Plast Chir"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1016\/j.injury.2011.08.015","article-title":"Scaphoid morphology and clinical outcomes in scaphoid reconstructions","volume":"43","author":"K Megerle","year":"2012","journal-title":"Injury"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1177\/1753193417739526","article-title":"Treatment of the scaphoid humpback deformity \u2013 is correction of the dorsal\n                    intercalated segment instability deformity critical?","volume":"43","author":"C L Mathoulin","year":"2018","journal-title":"J Hand Surg Eur Vol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1007\/s00402-006-0236-0","article-title":"The effects of extracorporeal shockwave on acute high-energy long bone fractures\n                    of the lower extremity","volume":"127","author":"C-J Wang","year":"2007","journal-title":"Arch Orthop Trauma Surg"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1007\/s00402-018-3087-6","article-title":"Treatment of scaphoid waist nonunion by one, two headless compression screws or\n                    plate with or without additional extracorporeal shockwave therapy","volume":"139","author":"S Quadlbauer","year":"2019","journal-title":"Arch Orthop Trauma Surg"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"404","DOI":"10.1055\/a-1250-8078","article-title":"Vergleich der Kahnbeinrekonstruktion mit einem nicht-vaskularisierten\n                    Knochentransplantat mit und ohne intraoperativer Sto\u00dfwellenanwendung \u2013\n                    vorl\u00e4ufige Ergebnisse","volume":"52","author":"M M\u00fchldorfer-Fodor","year":"2020","journal-title":"Handchir Mikrochir Plast Chir"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1055\/s-1999-13902","article-title":"Der DASH-Fragebogen \u2013 Ein neues Instrument zur Beurteilung von\n                    Behandlungsergebnissen an der oberen Extremit\u00e4t","volume":"31","author":"G Germann","year":"1999","journal-title":"Handchir Mikrochir Plast Chir"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1055\/s-2000-10915","article-title":"Vergleichende Ergebnisbewertung am Handgelenk \u2013 mediokarpale Teilarthrodese und\n                    Totalarthrodese","volume":"32","author":"H Krimmer","year":"2000","journal-title":"Handchir Mikrochir Plast Chir"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1055\/s-0042-104660","article-title":"Imaging of Scaphoid Fractures According to the New S3 Guidelines","volume":"188","author":"Deutsche Gesellschaft f\u00fcr Unfallchirurgie (DGU, Deutsche\n                            Gesellschaft f\u00fcr Orthop\u00e4die und Orthop\u00e4dische Chirurgie (DGOOC),\n                            Deutsche Gesellschaft f\u00fcr Handchirurgie (DGH), Deutsche Gesellschaft f\u00fcr\n                            Plastische Rekonstruktive und \u00c4sthetische Chirurgie (DGPR\u00c4C), Deutsche\n                            R\u00f6ntgengesellschaft (DRG), Deutsche Gesellschaft f\u00fcr Muskuloskelettale\n                            Radiologie (DGMSR)","year":"2016","journal-title":"R\u00f6Fo"},{"key":"ref20","first-page":"297","volume-title":"Skaphoidpseudarthrose","author":"R Schmitt","year":"2014"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1016\/j.jhsa.2017.09.022","article-title":"Scaphoid Healing Required for Unrestricted Activity: A Biomechanical Cadaver\n                    Model","volume":"43","author":"M S Guss","year":"2018","journal-title":"J Hand Surg"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1395","DOI":"10.1007\/s00402-018-2983-0","article-title":"Correlation of CT imaging and histology to guide bone graft selection in\n                    scaphoid non-union surgery","volume":"138","author":"G Schmidle","year":"2018","journal-title":"Arch Orthop Trauma Surg"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1002\/ca.21198","article-title":"Osseous microarchitecture of the scaphoid: Cadaveric study of regional\n                    variations and clinical implications","volume":"25","author":"S Lee","year":"2012","journal-title":"Clin Anat"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"650","DOI":"10.1016\/j.jhsa.2008.01.017","article-title":"Trabecular Microstructure at the Human Scaphoid Nonunion","volume":"33","author":"G Qu","year":"2008","journal-title":"J Hand Surg"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"332","DOI":"10.3892\/etm.2023.12031","article-title":"Extracorporeal shock wave treatment for post\u2011surgical fracture nonunion: Insight\n                    into its mechanism, efficacy, safety and prognostic factors (Review)","volume":"26","author":"H Wang","year":"2023","journal-title":"Exp Ther Med"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"4565","DOI":"10.1007\/s00402-023-04806-0","article-title":"Double screw versus angular stable plate fixation of scaphoid waist nonunions in\n                    combination with intraoperative extracorporeal shockwave therapy (ESWT)","volume":"143","author":"S Quadlbauer","year":"2023","journal-title":"Arch Orthop Trauma Surg"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1177\/1753193415604778","article-title":"Scaphoid fracture non-union: a systematic review of surgical treatment using\n                    bone graft","volume":"41","author":"D O Ferguson","year":"2016","journal-title":"J Hand Surg Eur Vol"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1023","DOI":"10.1007\/s00402-014-2007-7","article-title":"The effect of delayed treatment on clinical and radiological effects of anterior\n                    wedge grafting for non-union of scaphoid fractures","volume":"134","author":"S Euler","year":"2014","journal-title":"Arch Orthop Trauma Surg"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1055\/a-1250-8026","article-title":"Kahnbeinpseudarthrose: Erfahrungen aus mehr als 280 Rekonstruktionen mit einem\n                    vaskularisierten Knochenblock aus der medialen Femurkondyle","volume":"52","author":"K Kalb","year":"2020","journal-title":"Handchir Mikrochir Plast Chir"}],"container-title":["Handchirurgie \u00b7 Mikrochirurgie \u00b7 Plastische Chirurgie"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2701-8768.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T23:46:48Z","timestamp":1773186408000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2701-8768"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":28,"journal-issue":{"issue":"05","published-online":{"date-parts":[[2025,10,22]]},"published-print":{"date-parts":[[2025,9]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2701-8768","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0722-1819","1439-3980"],"issn-type":[{"value":"0722-1819","type":"print"},{"value":"1439-3980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9]]}}}