Low-intensity extracorporeal shock wave therapy for midshaft clavicular delayed union: A case report and review of literature

doi:10.12998/wjcc.v9.i27.8242

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World Journal of Clinical Cases

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Case Report

World J Clin Cases. Sep 26, 2021; 9(27): 8242-8248
Published online Sep 26, 2021. doi: 10.12998/wjcc.v9.i27.8242

Low-intensity extracorporeal shock wave therapy for midshaft clavicular delayed union: A case report and review of literature

Lei Yue, Hao Chen, Tian-Hao Feng, Rui Wang, Hao-Lin Sun

Lei Yue, Tian-Hao Feng, Rui Wang, Hao-Lin Sun, Department of Orthopaedics, Peking University First Hospital, Beijing 100034, China

Hao Chen, Department of Rehabilitation, Peking University First Hospital, Beijing 100034, China

Author contributions: Yue L, Chen H and Feng TH reviewed the literature and contributed to manuscript drafting; Chen H was the therapist of the patient; Yue L analyzed and interpreted the imaging findings; Sun HL and Wang R were the surgeons of the patient and responsible for the revision of the manuscript; all authors issued final approval for the version to be submitted.

Supported by Beijing Municipal Natural Science Foundation, No. 7212117.

Informed consent statement: Informed consent was obtained from the patient for the publication of this case report and any accompanying imaging.

Conflict-of-interest statement: The authors declare that they have no conflict of interest.

CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).

Corresponding author: Hao-Lin Sun, MD, Associate Professor, Department of Orthopaedics, Peking University First Hospital, No. 8 Xishiku Ave, Beijing 100034, China. sunhaolin@vip.163.com

Received: May 4, 2021
Peer-review started: May 4, 2021
First decision: June 24, 2021
Revised: July 5, 2021
Accepted: August 3, 2021
Article in press: August 3, 2021
Published online: September 26, 2021
Processing time: 135 Days and 7.2 Hours

Abstract

BACKGROUND

One of the most common complications following surgery for midshaft clavicle fracture is nonunion/delayed union. Extracorporeal shock wave therapy (ESWT) is an alternative to promote new bone formation without surgical complications. To date, no literature has reported low-intensity ESWT (LI-ESWT) in delayed union of midshaft clavicle fracture.

CASE SUMMARY

We reported a 66-year-old Chinese amateur cyclist with clavicle delayed union treated with 10 sessions of LI-ESWT (radial, 0.057 mJ/mm², 3 Hz, 3000 shocks). No anesthetics were applied, and no side effects occurred. At the 4 mo and 7 mo follow-ups, the patient achieved clinical and radiographical recovery, respectively.

CONCLUSION

In conclusion, our findings indicated that LI-ESWT could be a good option for treating midshaft clavicular delayed union.

Keywords: Shockwave therapy; Clavicle fracture; Delayed union; Extracorporeal shock wave therapy; Case report

Core Tip: Clavicle fracture is a common injury for cyclists, and surgical intervention could result in nonunion or delayed union. This is the first case report in the literature of low-intensity extracorporeal shock wave therapy treating midshaft clavicular delayed union. Our treatment protocol was unique in low-energy dosage, radial pattern, and multiple sessions. The clinical and radiographical outcomes were good, and the patient was able to return to sports, specifically amateur cycling, after a relatively short treatment period. The findings of this study could be particularly valuable for treating delayed union of clavicle fracture in athletes.