Extracorporeal Shockwave Therapy for the Treatment of Ulnar Shaft Fracture Delayed Union Following Open Reduction and Internal Fixation: A Case Report and Literature Review

Introduction: Isolated ulnar shaft fractures are uncommon injuries but are prone to developing delayed union. Delayed union of such fractures is a well-recognized complication, regardless of the type of treatment. The standard treatment for this complication initially involves observation, and if non-union develops, it is followed by internal fixation with a compression plate, combined with biological stimulation using an autologous iliac crest bone graft. Recently, extracorporeal shock wave therapy (ESWT) has been proposed as a non-operative alternative for the treatment of delayed union. The aim of the present study is to report the outcomes of ESWT in the treatment of ulnar shaft delayed union following initial surgical management with open reduction and internal fixation (ORIF) in a young patient. A brief review of the relevant literature is also presented on the topic. Case Report: A 19-year-old patient with an isolated ulnar shaft fracture was surgically treated with ORIF. At 12 weeks postoperatively, the patient presented with clinical and radiographic signs of delayed union. ESWT was employed to manage the delayed bone healing. After 10 sessions, the patient was symptom-free, with radiographic evidence of fracture consolidation. Conclusion: ESWT is considered a promising non-invasive alternative for the management of delayed fracture healing, demonstrating consistently successful outcomes. It has proven to be a safe, reliable, and highly effective modality, without the risks and complications typically associated with revision surgery.