{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T04:31:44Z","timestamp":1781843504162,"version":"3.54.5"},"reference-count":50,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,1,8]],"date-time":"2022-01-08T00:00:00Z","timestamp":1641600000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,1,8]],"date-time":"2022-01-08T00:00:00Z","timestamp":1641600000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Orthop Traumatol"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Long-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.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Materials and methods<\/jats:title>\n                <jats:p>49 patients with long-bone non-unions (femur and tibia) after nailing were treated with nail dynamization (group D, <jats:italic>n<\/jats:italic>\u2009=\u200915), fESWT (group S, <jats:italic>n<\/jats:italic>\u2009=\u200917) or nail dynamization in addition to fESWT (group DS, <jats:italic>n<\/jats:italic>\u2009=\u200917). Patients were followed up for 6\u00a0months 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.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Union 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 (<jats:italic>p<\/jats:italic>\u2009=\u20090.024). Successful treatment was correlated with high age (OR 1.131; 95% CI 1.009\u20131.268; <jats:italic>p<\/jats:italic>\u2009=\u20090.034), female gender (OR 0.009; 95% CI 0.000\u20130.89; <jats:italic>p<\/jats:italic>\u2009=\u20090.039), low NUSS score (OR 0.839; 95% CI 0.717\u20130.081; <jats:italic>p<\/jats:italic>\u2009=\u20090.028) and negative smoking status (OR 86.018; 95% CI 3.051\u20132425.038; <jats:italic>p<\/jats:italic>\u2009=\u20090.009).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Data 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.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Level of evidence<\/jats:title>\n                <jats:p>Level 3.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s10195-021-00620-9","type":"journal-article","created":{"date-parts":[[2022,1,8]],"date-time":"2022-01-08T09:02:47Z","timestamp":1641632567000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Addition of shock wave therapy to nail dynamization increases the chance of long-bone non-union healing"],"prefix":"10.1186","volume":"23","author":[{"given":"Josef","family":"Stolberg-Stolberg","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Fuchs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moritz F.","family":"Lodde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffen","family":"Ro\u00dflenbroich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patric","family":"Garcia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Raschke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Everding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,1,8]]},"reference":[{"key":"620_CR1","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1038\/nrrheum.2014.164","volume":"11","author":"TA Einhorn","year":"2015","unstructured":"Einhorn TA, Gerstenfeld LC (2015) Fracture healing: mechanisms and interventions. 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