Shock wave therapy useful for stress fractures

NEW YORK (Reuters Health) - Extracorporeal shock wave therapy (ESWT), a noninvasive technique that uses sound waves to stimulate healing, is an effective way to treat resistant stress fractures in athletes, according to a report of five cases in the American Journal of Sports Medicine.

Between 1997 and 2003, a total of 62 patients were treated with ESWT at the researchers' hospital, including five athletes with chronic stress fractures that failed to heal after medical or surgical therapy.

The athletes were between 13 and 22 years of age and fractures were located in the leg, pubic bone, ankle or foot. The patients were participants in baseball, basketball, marathon or soccer.

On average, the patients' fracture symptoms began 1 year prior to undergoing ESWT, lead author Dr. Masanori Taki, from Zensyukai Hospital Gunma Sports Medicine Research Center in Japan, and colleagues note. Each patient underwent one session of ESWT, performed under spinal anesthesia in an operating room.

Successful bone union was achieved in all cases roughly 3 months after ESWT and the subjects were then able to return to their sports after 3 to 6 months.

"We require additional basic and clinical studies to understand the effectiveness of ESWT," along with studies to determine the optimal energy level and impulse rate for the device, Taki's group concludes. "Nevertheless, when appropriately used, ESWT can be a safe and effective treatment for stress fractures, especially in resistant cases."

SOURCE: American Journal of Sports Medicine, July 2007.