TERAPIA DE ONDAS DE CHOQUE EXTRACORPÓREA (ESWT) NO TRATAMENTO DE FRATURAS COM ATRASO DE CONSOLIDAÇÃO OU PSEUDOARTROSE: REVISÃO SISTEMÁTICA E METANÁLISE

• DOI: https://doi.org/10.22533/at.ed.7991625120813

• Palavras-chave: pseudoartrose; terapia por ondas de choque; consolidação óssea; fratura; tratamento não invasivo; ortopedia regenerativa.

• Keywords: nonunion; shock wave therapy; bone healing; fracture; non-invasive treatment; regenerative orthopedics.

• Abstract: Nonunion and delayed union fractures represent a significant challenge in orthopedic practice, with major functional, social, and economic consequences. Extracorporeal Shock Wave Therapy (ESWT) has been proposed as a non-invasive alternative to stimulate osteogenesis through mechanisms such as angiogenesis, progenitor cell recruitment, and the release of growth factors. This systematic review and meta-analysis aimed to evaluate the efficacy of ESWT in long-standing fractures. Twelve studies (n = 980 patients) were included. ESWT significantly increased the union rate compared to conventional treatment (OR: 4.05; 95%CI: 2.46–6.68; I² = 0%), and consistently reduced the mean healing time (MD: –5.26 weeks; 95%CI: –6.25 to –4.27; I² = 0%). No significant increase in severe adverse events was observed. These findings support ESWT as an effective and safe therapeutic strategy for delayed union or nonunion fractures, with clinically relevant benefits, especially in patients contraindicated for invasive surgical approaches.