Efficacy and safety of extracorporeal shockwave therapy compared with surgery in management of delayed union and nonunion of fractures:a meta-analysis of randomized controlled trials
Objective To compare the efficacy and safety between extracorporeal shockwave therapy (ES-WT) and surgery in managing delayed union and nonunion of fractures by meta-analysis. Methods Related ran-domized controlled trials (RCTs) published until Oct. 2023 were comprehensively searched in the databases of CNKI,Wanfang,Pubmed,Cochrane Library and others. The inclusion criterion for grouping was ESWT for experi-mental group and surgery for control group. Outcome indexes included healing rate,healing time,incidence of side effects and costs. Results A total of 16 RCTs were included. The meta-analysis results showed that compared with surgery group,ESWT group revealed higher healing rate(OR=1. 720,95% CI:1. 240,2. 380,P=0. 001),shorter healing time (d,MD=-27.110,95% CI:-49.700,-4.510,P=0.020) and significantly lower costs(10,000 CNY,MD=-3.200,95% CI:-3.850,-2.560,P<0.001). Incidence of side effects showed no significant difference(RR=0.520,95% CI:0.100,2.860,P=0.450). Conclusion In the treatment of delayed union and nonunion following fractures,ESWT is superior to surgery alone,with higher healing rate,shorter healing time,no severe side effects and better cost-benefit,which is worth clinical promotion.
Bone nonunionDelayed union of fracturesExtracorporeal shockwave therapySurgeryMeta-analysis