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Effect of Extracorporeal Shockwave Therapy on Variable Foot & Ankle Musculoskelectal Diseases

Kiwon Young, Hunki Cho
Institution: Eulji Hospital Foot & Ankle Clinic, Seoul, Korea
Device and producing company: PiezoWave, WOLF
Introduction: ESWT is widely used in Orthopaedic Foot and Ankle Musculoskelectal
disease. Most commonly applied disease is plantar fasciitis. However, many other
disease can be applied for treatment between conservative and surgical treatment. We
applied ESWT on variable foot and ankle disease, that failed to treat conservative
method and before surgical treatment. Here we analyze variable disease and their effect
of ESWT in foot and ankle musculoskelectal fields.
Methods: Variable foot and ankle disease that is not effective in conservative
treatement were treated ESWT.
The diseases are plantar fasciitis, post op persistant pain(Excision of accessory
navicular, Anke instability with modified Brostrom procedure), acute and chronic ankle
sprain, pain at previous fracture site, bursitis, osteoarthritis and chondral lesion, Morton's
neuroma, contusion, and achilles tendinitis.
Retrospective analysis of prospectively collected clinical data of patients treated with
ESWT. 201 patients' data (Male: 69 , Female: 134) were collected satisfaction that
graded by 4 (Exellent-Good-Fair-Poor) at before and 2 weeks after the last treatment.
We defined the term 'Excellent' as pain relieved much better than before and the term
"Good" as pain relieved better than before, but not as much as "Excellent". "Fair" for on
change in pain, "Poor" defined as pain get worse than before. All the patient were failed
to other conservative treatment and before treatment of ESWT, satisfaction were F or P
state.
Results: The percentage of patients for
(1)Plantar fasciitis group was 58.7% of all patients and the results is 28% for Excellent,
50% for Good, 20% for Fair, 2% for Poor. (2)Post operative perisistent pain was 8.9% of
all patients and the results is 28% for Excellent, 50% for Good, 20% for Fair, 2% for
Poor. (3)Acute and chornic ankle sprain / Inflammtory disease such as tenosynovitis was
8.9% of all patients and its clinical outcome was 22% for Excellent, 67% for Good, 11%
for Fair, 0% for Poor. (4)Pain at previous fracture site that was treated by conservative
method was 2.9% of all patients and its clinical outcome was 33% for Excellent, 67% for
Good, 0% for Fair, 0% for Poor. (5)Bursitis was 2.9% of all patients and its clinical
outcome was 0% for Excellent, 83% for Good, 17% for Fair, 0% for Poor.
(6)Osteoarthitis and chondral lesion was 3.4% of all patients and 0%, 29%, 57%, 14%.
(7)Morton’s neurmoa was 5.9% of all patients and 16%, 16%, 68%, 0%. (8)Contusion
was 0.9% of all patients and 50%, 50%, 0%, 0%. (9)Achilles tendinitis was 6.9% of all
patients and 0%, 71%, 29%, 0% for Excellent, Good, Fair, Poor each.
We defined "Effectiveness of ESWT" when more than half of patient get better (that feel
Excellent or good). The disease being effective is Bursitis, both acute and chronic ankle
sprain, tenosynovitis, plantar fascia, Achilles tendinitis, fracture that didn't need to
operate, and contusion.
ESWT did not bring a satisfactory effect on Morton's neuroma. No serious complications
were observed.
33 Abstract 31Discussion: no
Conclusion: The ESWT can be applied variable foot and ankle disease as well as
plantar fasciitis. The effect of ESWT on variable foot and ankle disease is around 70%
and good result especially painful post op or after fracture status.
34The Effectiveness of Extracorporeal Shockwave
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