Combined Electromagnetic and Electrohydraulic Focused ESWT and EMTT for Delayed Calcaneal Union in an Adolescent Parkour Athlete - A Case Report

Abstract

This case report describes a novel and unique combination of both electromagnetic and electrohydraulic focused extracorporeal shockwave therapy (ESWT) and extracorporeal magnetotransduction therapy (EMTT) for accelerated healing in a calcaneus epiphyseal fracture with delayed healing in an adolescent Parkour athlete. After a 2.5m jump, the 14-year-old experienced significant heel pain, however avoided telling his parents. After eight weeks, the initial imaging using ultra low dose weight-bearing cone beam CT (WBCT) revealed a calcaneus non-union situation adjacent to the open calcaneal physis. To improve and accelerate bony healing substantially, we chose to apply both combined focused electromagnetic (Storz Ultra, Storz Medical AG, Tägerwillen, CH) and focused electrohydraulic (MTS, Konstanz, Germany) ESWT in a fractioned fashion plus EMTT (Storz Magnetolith, Tägerwillen, CH) in five consecutive weekly sessions while allowing the patient to fully weight bear. The follow-up WBCT after six weeks revealed a near to total healing of the delayed union and being pain-free. Notably, combination therapy with focused ESWT and EMTT did not result in early closure of the calcaneal epiphysis. We conclude that combined focused electromagnetic and electrohydraulic ESWT and EMTT facilitate bony healing in adolescent calcaneal apophyseal fractures without any adverse effects on the open physis. Evidence level IV (case report).

Keywords:

• ESWT
• shockwave therapy
• EMTT
• epiphysis
• non
• union

Abbreviations

EMTT, electromagnetic transduction therapy; ESWT, extracorporeal shockwave therapy; WBCT weight-bearing computer tomography; Hz, Hertz.

Ethics Approval and Informed Consent

The patient and his parents were informed that data from the case would be submitted for publication, and the parents gave consent. IRB approval was not required to publish this case report.

Disclosure

KK is a lecturer for Storz Medical and reports non-financial support from MTS for providing test machine. AS has nothing to disclose. WS is a consultant for MTS and reports personal fees from SoftWave TRT, outside the submitted work.

Additional information

Funding

There is no funding to report.