CASE REPORT article
Front. Surg.
Sec. Pediatric Orthopedics
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1667385
This article is part of the Research TopicFractures and Deformities of the Extremities in Children and Adolescents: Etiology, Diagnosis, and Treatment: 2025View all 3 articles
Radial Extracorporeal Shock wave Promotes the Treatment of Non-union of FemoralShaft Fractures in Children: A Case Report
Provisionally accepted
- People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, China
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Abstract: Background: Despite the minimally invasive benefits of flexible intramedullary nails (FIN) for pediatric femoral shaft fractures, nonunion may occur. Traditional surgical revisions carry high trauma and risk, while radial extracorporeal shockwave therapy (rESWT) has potential for promoting bone healing but lacks sufficient evidence in such pediatric cases.Methods: A 4-year-old male with left femoral shaft fracture (AO/OTA 32A2) and FDA-defined nonunion 9 months after FIN fixation received rESWT. Using Gymna ShockMaster 300 (Uniphy), parameters were 6–8 Hz, 2.0–3.0 bar, 1,000–1,500 pulses/week for 3–4 weeks (covering fracture and 2 cm around). Treatment included pre-procedural screening, professional operation, gamified communication, and concurrent rehabilitation.Results: Post-rESWT, fracture lines blurred then disappeared, with clinical healing achieved and no complications. At 3-month follow-up, intramedullary nail was removed; the patient had 80% weight-bearing capacity, independent walking (mild gait asymmetry), and full weight-bearing recovery later.Conclusion: rESWT effectively reverses post-FIN nonunion in pediatric femoral shaft fractures, with advantages of non-invasiveness, safety, and good compliance. It is a feasible alternative for surgery-limited cases, though long-term efficacy needs large-scale validation.
Keywords: Fracture nonunion, Delayed bone healing, Fracture, Radial extracorporeal shock wave, Flexible intramedullary nail, Children
Received: 18 Jul 2025; Accepted: 08 Sep 2025.
Copyright: © 2025 Shang, Ma, Liu, Yang, Luo, Li, Liang and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
He Shang, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, China
DeSheng Chen, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, China
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