Applications in Musculoskeletal Disorders - part 9 potx

mation was observed without bony consolida- tion. They concluded that high-energy ESWT was an excellent noninvasive treatment for pseudarthrosis and should be used as a pri- marytreatmentmethod.Beutleretal.(1999) reported 11 out of 27 patients healed (41%) 3 months after SWT with two times 2000 impulses at 18 kv. Schaden (2000) demon- stratesasuccessrateof75.4%in49nonuni- ons and of 75% in 15 infected nonunions. He suggestes that shock waves had a stimulating effect on osteoformation. In 2001, Schaden et al. had treated 115 patients with nonunions or delayed fracture healing. In 87 of the patients a single SWT resulted in bony consolidation. Wang and co-workers (2001) applied 6000 impulses at 28 kV for posttraumatic nonuni- ons of the femur and tibia, 3000 impulses at 28 kV for nonunions of the humerus, 2000 impulses at 24 kV for nonunions of the radius and ulna, and 1000 impulses at 20 kV for nonunions of the metatarsal bones. Alto- gether, 72 patients underwent SWT. The rate of bony unions was described as 40% at 3 months, 60.9 % at 6 months, and 80 % at 12 months. The least effectiveness was seen in atrophic nonunions. The current observational cohort study focused on the treatment of nonunions of femur or tibia, being defined as a fracture or osteotomy in which no radiological signs of cortical bridging occurred for at least 9 months after the last operative intervention. Stringent exclusion criteria were applied, SWT was standardized, and adjunct treatment remained unchanged. The decision whether bony healing had occurred was made by an independent observer. Radiological success was seen in 72% of the patients, and a clear connection with a positive tracer uptake in the mineralization phase of bone scintigraphy. Therefore, patients with a scintigraphically inactive pseudarthrosis are excluded. Six out of eight patients with an inactive pseudar- throsis and subsequent treatment failure after ESWT smoked, each more than 20 cigarettes per day. In the knowledge of a possible direct relationship between the development of a nonunion and the presence of nicotine (Silcox et al. 1995) we recommended our patients stop smoking before starting with high- energy ESWT. Several weak points of the current study deserve attention. Firstly, the suggestions of the Food and Drug Administration panel of the United Stated Department of Health and Human Services of 1986 (Taylor 1992) for the definition of a pseudarthrosis were only par- tially adopted: the determination of visible progressive signs of healing for 3 months were excluded because according to the radiological department involved in the cur- rent study this criterion should not be used as asuccessparameterbecauseofthewide range of interobserver variability in its assess- ment. It was thought that if cortical consolida- tion had not appeared after 9 months in long bones, spontaneous union had to be regarded as improbable, even in hypertrophic, hyper- vascular nonunions as shown in Figure 8.3. One may wonder whether the nonunion would have united spontaneously. However, in this case, as in all the others, it was an inde- pendent observer who diagnosed a nonunion, and operative revision could have been sug- gested at this point. Secondly, the author attempted to select a homogenous group of patients. But it is evi- dent that there may be differences between healing times of posttraumatic and postosteo- tomy nonunions. With the small number of patients available, an individual statistical comparison of the two groups would have given no adequate statistical information. Nevertheless, better results were observed after postosteotomy than after postfracture nonunions. Thirdly, there is no control group. Naturally, whenever a new method of treatment is sug- gested it must be compared with an adequate set of controls. A study design with a placebo control had been dismissed as unethical. The alternative must be the comparison of high- energy ESWT and a standardized operative or conservative procedure. The author strongly favors a multicenter study. Given the small number of our patients available in one department, an additional subdivison into Discussion 69 two treatment groups would have given no adequate information from a statistical point of view. Beyond the preliminary clinical studies, the author is not aware of any other studies that document the effectiveness of high-energy ESWT in the treatment of pseudarthrosis. The author thinks that additional clinical corrobo- ration of the stimulation of bone healing with use of standardized high-energy extracorpo- real shock waves is highly recommended, and may lead to useful application of shock waves in the treatment of pseudarthroses, and a determination of the total energy most likely to accomplish healing. 8 Extracorporeal Shock Wave Application in the Treatment of Nonunions70 References Altchek DW, Warren RF, Wickiewicz TL. Arthro- scopic acromioplasty: technique and results. J. Bone Joint Surg. 1990; 72A:1198–207. Ark JW, Flock TJ, Flatow EL, Bigliani LU. Arthroscopic treatment of calcific tendinitis of the shoulder. Arthroscopy 1992; 8:183–188. Atkins D, Crawford F, Edwards J, Lambert M. A sys- tematic review of treatments for the painful heel. Rheumatology 1999; 38:968–973. Augat P, Claes L, Suger G. In vivo effects of shock waves on the healing of fractured bone. Clin. Bio- mech. 1995; 10:374–378. Auersperg V. Orthopaedic ESWT of soft tissues. Stoßwelle. 1998; 2:16–21. Backman C, Boquist L, Friden J, Lorentzon R, Toola- nen G. Chronic Achilles paratenonitis with tendi- nosis: an experimental model in the rabit. J. Orthop. Res. 1990; 8:541–547. Barrett SL, Day SV. Endoscopic plantar fasciotomy for chronic plantar fasciitis/heel spur syndrome: sur- gical technique, early clinical results. J. Foot Surg. 1991; 30:568–570. Basset CAL. Effects of electric currents on bone in vivo. Nature 1964; 204:643. Bassett CAL. The development and application of pulsed electromagnetic fields for ununited frac- tures and arthrodesis. Orthop. Clin. North Am. 1984; 15:61–64. Benson K, Hartz AJ. A comparison of observational studies and randomized, controlled trials. N Engl J Med. 2000;342:1878–1886. Benton-WeilW,BorelliAH,WeilLSJr.,WeilLSSr. Percutaneous plantar fasciotomy: a minimally invasive procedure for recalcitrant plantar fascii- tis. J. Foot Ankle Surg. 1998; 37:269–272. Berkowitz JF, Kier R, Rudicel S. Plantar fasciitis: MR imaging. Radiology 1991; 179:665–667. Besch L, Bielstein D, Schuckart M, Zenker W. Analyse von 55 posttraumatischen Pseudarthrosen nach Unterschenkelfraktur. Zentralbl. Chir. 1994; 119:702–705. Beutler S, Regel G, Pape HC, Machtens S, Weinberg AM,KremeikeI,JonasU,TscherneH.Dieextrakor- porale Stoßwellentherapie (ESWT) in der Behand- lung von Pseudarthrosen des Röhrenknochens. Erste Ergebnisse einer prospektiven klinischen Untersuchung. Unfallchirurg 1999; 102:839–847. Bhan S, Mehara AK. Percutaneous bone grafting for nonunion and delayed union of fractures of the tibial shaft. Int. Orthop. 1993; 17:310–312. Bigliani LU, Morrison DS, April EW. The morphology of the acromion and its relationship to the rotator cuff tears. Orthop. Trans. 1982; 10:228–233. Blanco CE, Leon HO, Guthrie TB. Endoscopic treat- ment of calcaneal spur syndrome: A comprehen- sive technique. Arthroscopy. 2001;17:517–522. Bogduk N. Innervation and pain patterns of the cervical spine. In: Grant R, ed. Clinics in physical therapy: physical therapy of the cervical and thoracic spine. New York: Churchill Livingstone; 1994:65–76. BoschU,SkutekM,KasperczykWJ,TscherneH.Dia- physäre Oberarmpseudarthrosen – operative und konservative Behandlung. Chirurg 1999; 70:1202–1208. Bosworth DM. Calcium, deposits in the shoulder and subacromial bursitis. JAMA 1941; 116:2482–2485. Boxberg W, Perlick L, Giebel G. Shock wave treat- ment for refractory soft-tissue pain. Chirurg. 1996; 67:1174–1178. Boyer MI, Hastings H. Lateral tennis elbow: Is there any science out there? J. Shoulder Elbow Surg. 1999; 8:481–491. Braun W, Rueter A. Frakturheilung. Morphologische und physiologische Gesichtspunkte. Unfallchirurg 1996; 99:59–67. BruemmerF,BraeunerT,HuelserDF.Biological effects of shock waves. World J. Urol. 1990; 8:224–232. Brunner W, Thüringer R, Ascher G, Neuking A, Flesch A, Solleder A. The extracorporeal shock wave ther- apy in orthopaedic surgery: results of 443 cases after 3 months. Orthop. Praxis 1997; 33:461–464. Buch M, Fleming L, Theodore G, Amendola A, Bach- mann C, Zingas C. Resultate einer prospektiven placebokontrollierten randomisierten doppelblin- den Multicenterstudie zur Evaluation der Effekti- vität und Sicherheit der Stoßwellentherapie bei plantarer Fasciitis. Lecture, Symposium Musculo- skeletal Shock Wave Therapy, Mainz, 2001. Bürger RA, Witzsch U, Haist J, Karnovsky V. Extrakor- porale Stoßwellenbehandlung bei Pseudarthrose und aseptischer Knochennekrose. Urologe A 1991; 30:48–49. Butler DS. Ein typischer Tennisellenbogen. In: Butler DS, ed. Mobilisation des Nervensystems. Berlin: Springer; 1995:415–420. Cass AS, Doce CD, Ugarte RR. Extracorporeal shock wave lithotripsy induced stimulation of the obtu- rator nerve. J. Urol. 1994; 151:144–145. Cattaneo R, Catagni MA, Guerreschi F. Applications of the Ilizarov method in the humerus. Hand Clin. 1993; 9:729–739. Chard MD, Hazleman BL. Tennis elbow – a reap- praisal. Brit. J. Rheumatol. 1989; 28:186–192. Chapman JF. Subacromial bursitis and supraspinatus tendinitis: its roentgen treatment. Calif. Med. 1942; 56:248–251. Chaussy C, Forssmann B, Brendel W, Jocham D, Eisenberger F, Hepp W, Gokel JM. Berührungsfreie Nierensteinzertrümmerung durch extrakorporal erzeugte, fokussierte Stoßwellen. Beiträge zur Urologie. Band 2. Basel: Karger; 1980. Chen H-S, Chen L-M, Huang T-W. Treatment of pain- ful heel syndrome with shock waves. Clin. Orthop 2001; 387:41–46 Coles C.P, Gross M. Closed tibial shaft fractures: Management and treatment complications. Can. J. Surg. 2000; 43:256–262. Concato J, Shah N, Jorwitz RI. Randomized, controlled trials, observational studies, and the hierarchy of research. N Engl J Med. 2000; 342:1887–1892. Constant CR, Murley AHG. A clinical method of func- tional assessment of the shoulder. Clin. Orthop. 1987; 214:160–164. Conti RJ, Shinder M. Soft tissue calcifications induced by local cortico-steroid injection. J. Foot Surg. 1991; 30:34–37. Crawford F, Atkins D, Edward J. Interventions for treating plantar heel pain (Cochrane Review). In: TheCochraneLibrary,Issue3.Oxford:Update Software; 2000. Cyriax J. Textbook of orthopaedic medicine. 11th edition. London: Balli`ere Tindall; 1982. Daecke W, Loew M, Schuknecht B. Der Einfluß der Applikationsdichte auf die Wirksamkeit der ESWA bei der Tendinosis calcarea der Schulter. Orthop. Praxis 1997; 33:119–123. Damien CJ, Parsons JR. Bone graft and bone graft substitutes. A review of current technology and applications. J. Appl. Biomech. 1991; 2:187–208. Day BH, Govindasamy N, Patnaik R. Corticosteroid injections in the treatment of tennis elbow. Practi- tioner 1978; 220:459–465. de Branche B. Analysis of 58 cases of tendinitis in the elbow region treated by manipulation of the cer- vical spine. Manuelle Medizin 1988; 26:77–80. Delius M. Medical applications and bioeffects of extracorporeal shock waves. Shock Waves 1994; 4:55–72. Delius M. Biomedical shock wave research: a brief update. In: Chaussy C, Eisenberger F, Jocham D, Wilbert D, eds. High energy shock waves in medi- cine. Stuttgart: Thieme; 1997:1–14. Delius M, Draenert K, Aldiek Y, Draenert Y. Biological effects of shock waves: in vivo effect of high energy pulses on rabbit bone. Ultrasound Med. Biol. 1995; 21:1219–1225. Delius M, Enders G, Heine G, Stark H, Remberger K, Brendel W. Biological effects of shock waves – lung hemorrhage by shock waves in dogs – pres- sure dependence. Ultrasound Med. Biol. 1987; 13:61–67. Deliveliotis C, Picramenos D, Kiriakakis C, Kiriazis P, Alexopoulou K, Kostakopoulos A. Stimulation of the obturator nerve during extracorporeal shock wave lithotripsy. Int. Urol. Nephrol. 1995; 27:515–519. de Marco F, Ricci MG, Bonaiuti D. Clinical trials among worker populations: the value and signifi- cance of anamnestic findings and clinical and instrumental tests for diagnosing work-related musculoskeletal disorders of the upper limb. Ergonomics 1998; 41:1322–1339. De Palma AF, Kruper JS. Long-term study of shoulder joints afflicted with and treated for calcific tendi- nitis. Clin. Orthop. 1961; 20:61–72. Diesch R, Haupt G. Anwendung der hochenergeti- schen extrakorporalen Stoßwellentherapie bei Pseudarthrosen. Orthop Praxis 1997; 33:470–471. Donath K, Breuner G. A method for the study of undecalcified bones and teeth with attached soft tissue. J. Oral Pathol. 1982; 11:318–323. Ehmer B. Orthopädische Erkrankungen des Ellenbo- gengelenkes. In: Ehmer B, ed. Orthopädie und Traumatologie für Physiotherapeuten. Stuttgart: Ferdinand Enke; 1988:251–255. Ekkernkamp A, Haupt G, Knopf H.J. Effects of extra- corporeal shock waves on standardized fractures in sheep. Urology 1991; 145:257–261. Ekkernkamp A, Bosse A, Haupt G, Pommer A. Der Einfluß der extrakorporalen Stoßwellen auf die standardisierte Tibiafraktur am Schaf. In: Ittel T, Sieberth G, Matthiaß H, eds. Aktuelle Aspekte der Osteologie. Berlin: Springer; 1992:307–310. Ellman H. Arthroscopic subacromial decompression: analysis of one to three year results. Arthroscopy 1987; 3:173–181. Ellman H, Kay SP. Arthroscopic subacromial decom- pression for chronic impingement: two to five year results. J. Bone Joint Surg. 1991; 73B:395–398. Esch JC, Ozerkis LR, Helgager JA. Arthroscopic subac- romial decompression: results according to the degree of rotator cuff tear. Arthroscopy 1988; 4:241–249. FarinPU,RasanenH,JaromaH,HarjuA.Rotatorcuff calcifications: treatment with ultrasound-guided percutaneous needle aspiration and lavage. Skele- tal Radiol. 1996; 25:551–554. Finestone H, Helfenstein S. Spray bottle epicondyli- tis. Diagnosing and treating workers in pain. Can. Fam. Phys. 1994; 40:336–337. References72 FoleyAE.Tenniselbow.Am.Fam.Physician1993; 48:281–288. Forriol F, Solchaga L, Moreno JL, Canadell J. The effect of shock waves on mature and healing cortical bone. 1994; 8:325–329. Frankel VH, Ryaby JP, Hagenmeyer K, McCabe J. The effects of low-intensity pulsed ultrasound on the healing of fractures. Abstract. SICOT 96 Congress, Amsterdam, 1996. Friedenberg ZB, Roberts PG, Didizian NH, Brighton CT. Stimulation of fracture healing by direct cur- rent in the rabbit fibula. J. Bone Joint Surg. 1971; 53A:1400–1408. Fukada E, Yasuda K. On the piezoelectric effect of bone. J. Phys. Soc. Japan 1957; 12:1158–1162. Gaertner J. Tendinosis calcarea – Behandlungsergeb- nisse mit dem Needling. Z. Orthop. Ihre Grenzgeb. 1993; 131:461–469. GartsmanGM,BlairME,NoblePC.Arthroscopicsub- acromial decompression: an anatomical study. Am. J. Sports Med. 1988; 16:48–50. Gelberman RH, Steinberg D, Amiel D, Akeson W. Fibroblast chemotaxis after tendon repair. J. Hand Surg. 1991; 16:686–693. Gerdesmeyer L, Bachfischer K, Peters P, Gradinger R. The indication of the application of high energetic extracorporeal shock waves in the treatment of pseudarthrosis – clinical and radiological results. Lecture, 2nd International Congress of the Euro- pean Society for Musculoskeletal Shock wave Therapy, London, 1999. Göbel F, Huber R, Hein W. Stellenwert der extrakor- poralen Stoßwellenbehandlung bei therapieresis- tenter Epicondylitis humeri radialis. Z. Orthop. Ihre Grenzgeb. 1997; 135A:95. Graff J. Die Wirkung hochenergetischer Stoßwellen auf Knochen und Weichteilgewebe. Habilitations- schrift. Ruhr-Universität Bochum, 1989. Graff J, Richter KD, Pastor J. Effect of high energy shock waves on bony tissue. Urol. Res. 1988; 16:252–258. Grasel RP, Schweitzer ME, Kovalovich AM, Karsick D, Wapner K, Hecht P, Wander D. MR imaging of plantar fasciitis: edema, tears, and occult marrow abnormalities correlated with outcome. Am. J. Roentgenol. 1999; 173:699–701. Grieve G. Referred pain and other clinical features. In: Boyling J, Palastanga N, eds. Grieve’s modern manual therapy: The vertebral column. Edin- burgh: Churchill Livingstone; 1994:271–292. Griffin EJ, Karselis TC. Physical agents for physical therapists. In: Griffin EJ, ed. Ultrasonic Energy. Springfield: Charles C Thomas; 1982: Gschwend N, Scherer M, Loehr J. Die Tendinitis cal- carea des Schultergelenks. Orthopäde 1981; 10:196–205. Gunn C, Milbrandt W. Tennis elbow and the cervical spine. Can. Med. Assoc. 1976; 114:803–809. Haake M, Boeddeker I. ESWT bei Epicondylitis radia- lis – Ergebnisse der prospektiven placebokontrol- lierten Multicenterstudie der DGOT. Lecture, Sym- posium Musculoskeletal Shock Wave Therapy, Mainz, 2001. HaakeM,ThonA,BetteM.Absenceofspinal response to extracorporeal shock waves on the endogene opioid system in the rat. Ultrasound Med. Biol. 2001; 27:279–284. Habermeyer P, Hansen N, Jung D. Arthroskopisch- chirugische Maßnahmen am Schultergelenk. Chi- rurg 1998; 68:1085–1092. Hagelauer U, Russo S, Gigliotti S, de Durante C, Cor- rado EM. Interactive navigation system for shock wave applications. Comput. Aided Surg. 2001; 6:22–31. Hammer DS, Rupp S, Ensslin S, Kohn D, Seil R. Extra- corporeal shock wave therapy in patients with tennis elbow and painful heel. Arch. Orthop. Trauma Surg. 2001; 120:304–307. Harmon PH. Methods and results in the treatment of 2580 painful shoulders. Am. J. Surg. 1958; 95:527–544. HasegawaS,KatoK,TakashiM,ZhuY,ObataK,Miy- ake K. S100a0 protein as a marker for tissue dam- age related to extracorporeal shock wave litho- tripsy. Eur. Urol. 1993; 24:393–395. Haupt G. Use of extracorporeal shock waves in the treatment of pseudarthrosis, tendinopathy and other orthopedic diseases. J. Urol. 1997; 158:4–11. Haupt G, Haupt A, Ekkernkamp A, Gerety B, Chvapil M. Influence of shock waves on fracture healing. Urology. 1992; 39:529–532. Hawkins R, Kennedy JC. Impingement syndrome in athletes. Am. J. Sports Med. 1980; 8:151–158. HeckmanJD,RyabyJP,McCabeJ,FreyJJ,KilcoyneRF. Acceleration of tibial fracture-healing by non- invasive low-intensity pulsed ultrasound. J. Bone Joint Surg. 1994; 76A:26–34. Hedtmann A, Fett A. Die sogenannte Periarthropa- thia humero-scapularis – Klassifizierung und Ana- lyse anhand von 1266 Fällen. Z. Orthop. Ihre Grenzgeb. 1989; 127:643–649. Hefti F, Stoll TM. Heilung von Ligamenten und Seh- nen. Orthopäde 1995; 24:237–45. Heller KD, Niethard FU. Der Einsatz der extrakorpo- ralen Stoßwellentherapie in der Orthopädie – eine Metaanalyse. Z. Orthop. Ihre Grenzgeb. 1998; 136:390–401. Henney JE. From the food and drug administration: shock wave for heel pain. JAMA 2000; 284:2711. Henricson AS, Westlin NE. Chronic calcaneal pain in athletes: entrapment of the calcaneal nerve? Am J Sports Med. 1984; 12:152–154. Hessling KH, Schlick RW, Luckey R, Gratz K, Allhoff EP. Die therapeutische Wertigkeit der ambulanten extrakorporalen Stoßwellenlithotripsie von speichelsteinen. Ergebnisse einer prospektiven Studie. Laryngorhinootologie 1993; 72:109–115. Huguenin F. Epicondylalgia in manual medicine. Manuelle Medizin 1988; 26:73–76. References 73 Hulth A. Current concepts of fracture healing. Clin. Orthop. 1989; 249:265–284. IkedaK,TomitaK,TakayamaK.Applicationofextra- corporeal shock wave on bone: preliminary report. J. Trauma 1990; 47:946–950. Jerosch J, Strauss JM, Schmiel S. Arthroscopic treat- ment of calcific tendinitis of the shoulder. J. Shoul- der Elbow Surg. 1998; 7:30–37. Johannes EJ, Kaulesar Sukul DM, Matura E, Schutte HE. High-energy shock waves for the treatment of nonunions: an experiment on dogs. J. Surg. Res. 1994; 57:246–254. Kay S.P, Amstutz HC. Shoulder hemiarthroplasty at UCLA. Clin. Orthop. 1988; 228:42–48. Kilcoyne RF, Reddy PK, Lyons F. Optimal plain film imaging of the shoulder impingement syndrome. Am. J. Roentgenol. 1989; 53:795–797. Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS, Sanders M. Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int. 1994; 15:349–53. Kogler GF, Veer FB, Verhulst SJ, Solomonidis SE, Paul JP. The effect of heel elevation on strain within the plantar aponeurosis: in vitro study. Foot Ankle Int. 2001; 22:433–9. KöhrmannKU,BackW,BensemannJ,FlorianJ, WeberA,KahmannF,RassweilerJ,AlkenP.The isolated perfused kidney of the pig: new model to evaluate shock wave-induced lesions. J. Endourol. 1994; 8:105–110. Krause H. Physik und Technik medizinischer Stoßwel- lensysteme. In: Rompe JD. Extrakorporale Stoßwel- lentherapie. London: Chapmann &Hall; 1997:15–34. Kraushaar BS, Nirschl RP. Current concepts review. Tendinosis of the elbow (tennis elbow). J. Bone Joint Surg. 1999; 81A:259–278. Krischek O, Rompe JD, Zöllner J. Extrakorporale Stoßwellentherapie bei der Tendinosis calcarea der Schulter – eine kritische Bestandsaufnahme nach einem Jahr. Phys. Rehab. Kur Med. 1997; 7:272–277. KrischekO,RompeJD,HerbsthoferB,NafeB.Sym- ptomatische niedrig-energetische Stoßwellenthe- rapie bei Fersenschmerzen und radiologisch nach- weisbarem Fersensporn. Z. Orthop. Ihre Grenzgeb. 1998; 136:169–174. Krischek O, Hopf C, Nafe B, Rompe JD. Shock-wave therapy for tennis and golfer’s elbow. Arch. Orthop. Trauma Surg. 1999; 119:62–66. Kristiansen TK. The effect of low power specifically programmed ultrasound on the healing of fresh fractures using a Colle’s model. J. Orthop. Trauma 1990; 4:227–228. Kuner EH, Berwarth H, Lücke SV. Behandlungsprin- zipien bei aseptischen Pseudarthrosen. Ortho- päde 1996; 25:394–404. KvistM,JozsaL,JärvinenM,KvistH.Chronic Achilles paratenonitis in athletes: a histological and histochemical study. Pathol. 1987; 19:1–11. Labelle H, Guibert R, Newman N, Fallaha M, Rivard C-H. Lack of scientific evidence for the treatment of lateral epicondylitis of the elbow. J. Bone Joint Surg. 1992; 74B:646–651. Lapidus PW. Infiltration therapy of acute tendinitis with calcification. Surg. Gynecol. Obstet. 1943; 76:715–725. Lapidus PW, Guidotti FP. Painful heel: Report of 323 patients with 364 painful heels. Clin. Orthop. 1965; 39:178–185. Leach R, Jones R, Silva T. Rupture of the plantar fascia in athletes. J Bone Joint Surg. 1978; 60–A:537–539. Leach RE, DiIorio E, Harney RA. Pathologic hindfoot conditions in the athlete. Clin Orthop. 1983; 177:116–121. Lehmann EL. Nonparametrics: Statistical methods based on ranks. San Francisco: Holden-Day; 1975. Litchman HM, Silver CM, Simon SD. The surgical management of calcific tendinitis of the shoulder. Int. Surg. 1968; 50:474–482. Loehr JF, Uhthoff HK. Tendinosis calcarea. Orthopäde 1996; 25:484–493. Loew M, Jurgowski W, Mau HC, Thomsen M. Treatment of calcifying tendinitis of rotator cuff by extracorporeal shock waves: a prelimi- naryreport.J.ShoulderElbowSurg.1995; 4:101–106. Loew M, Daecke W, Kusnierczak D, Rahmanzadeh M, Ewerbeck V. Extracorporal shock wave application – an effective treatment for patients with chronic and therapy-resistant calcifying tendinitis? J. Bone Joint Surg. 1999; 81B:863–867. Lohrer H, Schöll J, Alt W, Hirschmann M. Die extra- korporaleStoßwellentherapie–ersteErgebnisse beim Einsatz in der Sportorthopädie. Leistungs- sport 1998; 2:42–44. Lonner JH, Siliski JM, Jupiter JB, Lhowe DW. Posttrau- matic nonunion of the proximal tibial metaphysis. Am. J. Orthop. 1999; 28:523–528. Lubock P. The physics and mechanics of lithotripters. Dig. Dis. Sci. 1989; 34:999–1005, Maier M, Steinborn M, Staebler A, Koehler S, Pfahler M, Dürr H-R, Refior H-J. Extracorporeal shock wave application for chronic plantar fasciitis – prediction of outcome by imaging? J. Rheumatol. 2000a; 27:2455–2461. Maier M, Stabler A, Lienemann A, et al. Shockwave application in calcifying tendinitis of the shoulder – prediction of outcome by imaging. Arch. Orthop. Trauma Surg. 2000b; 120:493–498. Maier M, Saisu T, Beckmann J, Delius M, Grimm F, HupertzV,MilzS,NerlichA,RefiorHJ,SchmitzC, Ueberle F, Weiler C, Messmer K. Impaired tensile strength after shock wave application in an animal model of tendon calcification. Utrasound Med. Biol. 2001; 27:665–671. Maigne R. Manipulative treatment in patients with epicondylagia. Manuelle Medizin 1988; 26:69–72. References74 Maitland GD. Peripheral manipulation. 3rd ed. Oxford: Butterworth Heinemann; 1991. MartinRL,IrrgangJJ,ContiSF.Outcomestudyof subjects with insertional plantar fasciitis. Foot Ankle Int. 1998; 19:803–8011. Maurer W, Hothorn LA, Lehmacher W. Multiple comparison in drug clinical trials and preclinic assays: a-priori ordered hypotheses. In: Vollmer J, ed. Biometrie in der pharmazeutischen Industrie. Vol. 6, Testing principles in clinical and preclinical trials. Stuttgart: Fischer; 1995:3–18. McCormack D, Lane H, McElwain J. The osteogenic potentialofextracorporealshockwavetherapy: an in vivo study. Irish J. Med. Sci. 1996; 165:20–22. MelzackR.Folkmedicineandthesensorymodulation ofpain.In: WallPD, Melzack R, eds.Textbookofpain. 3rd ed. Edinburgh: Churchill Livingstone; 1994 Mohr W. Pathologie des Bandapparates. Sehnen, Sehnenscheiden, Faszien, Schleimbeutel. In: Doerr W, Seifert G, eds. Spezielle pathologische Anato- mie. Band 19. Berlin: Springer; 1987 Mol´eD,KempfJF,GleyzeP.R´esultats du traitement arthroscopique des tendinopathies non-rompues de la coiffe des rotateurs. 2. Calcifications de la coiffe. Rev Chir. Orthop. Reparatrice Appar. Mot. 1993; 79:532–541. Neer II CS. Anterior acromioplasty for the chronic impingement syndrome in the shoulder. A prelim- inary report. J. Bone and Joint Surg. 1972; 54A:41–50. OgdenJA,AlvarezR,LevittR,CrossGL,MarlowM. Extracorporeal shock wave therapy for chronic plantar fasciitis. Clin. Orthop. 2001; 387:47–59. Perlick L, Boxberg W, Giebel G. High energy shock wave treatment of the painful heel spur. Unfallchi- rurg 1998; 101:914–918. PerlickL,GasselF,ZanderD,SchmittO,WallnyT. Comparison of the medium energetic extracorpo- ral shock wave therapy and surgical treatment of chronic epicondylitis humeri radialis – a one year follow-up. Z. Orthop. 1999a; 137:316–321. Perlick L, Korth O, Wallny T. Die Desintegrationswir- kung der Stoßwellen bei der extrakorporalen Stoßwellenbehandlung der Tendinois calcarea – eininvitroModell.Z.Orthop.IhreGrenzgeb. 1999b; 137:10–16. Perlick L, Wallny T, Zander D. Einfluß der Energief- lußdichteaufdieResorptionsratederKalkdepots bei der Stoßwellentherapie der Tendinosis calca- rea – Ein-Jahres-Ergebnisse. Orthop. Praxis. 1999c; 35:355–360. Perren SM. Aktivierung der Knochenbildung durch Stosswellentherapie in der Frakturbehandlung. Davos: AO Forschungsinstitut; 1993. PfefferG,BacchettiP,DelandJ,LewisA,AndersonR, DavisW,AlvarezR,BrodskyJ,FreyC,HerrickR, Myerson M, Sammarco J, Janecki C, Ross S, Bow- man M, Smith R. Comparison of custom and pre- fabricated orthoses in the initial treatment of proximal plantar fasciitis. Foot Ankle Int. 1999; 20:214–221. Pfister J, Gerber H. Behandlung der Periarthropathia humero-scapularis calcarea mittels Schulter- kalkspülung: retrospektive Fragebogenanalyse. Z. Orthop. Ihre Grenzgeb. 1994; 132:300–305. Pienimäki T, Kauranen K, Vanharanta H. Bilaterally decreased motor performance of arms in patients with chronic tennis elbow. Arch. Phys. Med. Reha- bil. 1998; 78:1092–1095. Pienkowski D, Pollack SR, Brighton CT, Griffith NJ. Low-power electromagnetic stimulation of osteo- tomized rabbit fibulae. J. Bone Joint Surg. 1994; 76A:489–501. Pigozzi F, Giombini A, Parisis A, Casciello G, Di Salvo V, Santori N, Mariani PP. The application of shock wave therapy in the treatment of resistant chronic painfulshoulder.J.SportsMed.Phys.Fitness 2000; 40:356–361. PillaAA,MontMA,NasserPR,KhanSA,Figueiredo M, Kaufman JJ, Siffert RS. Non-invasive low- intensity pulsed ultrasound accelerates bone healing in the rabbit. J. Orthop. Trauma 1990; 4:246–253. Plaisier PW, van der Hul RL, Terpstra OT, Bruining H. Current role of extracoporeal shock wave therapy in surgery. Br. J. Surg. 1994; 81:174–181. Plenk HP. Calcifying tendinitis of the shoulder. Radi- ology 1952; 59:384–408. Postacchini F, Accinni L, Natali PG, Ippolito E, DeMar- tino C. Regeneration of rabbit calcanaeal tendon. A morphological and immunohistochemical study. Cell.TissueRes.1987;145:81–97. PratF,RonchonT,BergerF,ChapelonJY,GagnonP, Cathignol D. Hepatic lesions in the rabbit induced by acoustic cavitation. Gastroenterology. 1991; 100:1345–1350. Probe RA, Baca MA, Adams R, Prece C. Night splint treatment for plantar fasciitis. A prospective ran- domized study. Clin. Orthop. 1999; 368:190–195. Rahn BA. Intra vitam staining techniques. In: von Recum AF, ed. Handbook of biomaterial evaluation. Scientific, technical and clinical testing of implant materials. New York: Macmillan; 1986:471–487. RawatB,WolberR,BurhenneH.J.Long-termsoft- tissue effects of biliary extracorporeal shock waves: an animal study. Am. J. Roentgenol. 1991; 156:73–76. Re jr. LP, Karzel RP. Management of rotator cuff calci- fications. Orthop. Clin. North Am. 1993; 24:125–132. Reichelt A. Konservative versus operative Therapie der Tendinosis calcarea. In: Springorum H-W, Kat- thagen B-D, eds. Aktuelle Schwerpunkte der Orthopädie 6. Stuttgart: Thieme: 1996:59–64. Rijnberg WJ, van Linge B. Central grafting for persis- tent nonunion of the tibia. A lateral approach to the tibia, creating a central compartment. J. Bone Joint Surg. 1993; 75B:926–931. References 75 Rochwerger A, Franceschi JP, Viton JM. Surgical man- agement of calcific tendinitis of the shoulder: an analysis of 26 cases. Clin. Rheumatol. 1999; 18:313–316. Rodriguez de Oya R, Sanchez Benitez de Soto J, Gar- cia Munilla M. Treatment of non-union with extracorporeal shock waves. Lecture, International Congress of the European Society for Musculo- skeletal Shock Wave Therapy, London, 1999. Roetert EP, Brody H, Dillmann CJ, Groppel JL, Schul- theisJM.Thebiomechanicsoftenniselbow.An integral approach. Clin. Sports Med. 1995; 14:47–57. Roles NC, Maudsley RH. Radial tunnel syndrome: resistant tennis elbow as nerve entrapment. J. Bone Joint Surg. 1972; 54B:499–508. Rompe JD, Rumler F, Hopf C, Nafe B, Heine J. Extra- corporal shock wave therapy for calcifying tendi- nitis of the shoulder. Clin. Orthop. 1995; 321:196–201. Rompe JD, Hopf C, Küllmer K, Heine J, Bürger R. Analgesic effect of extracorporeal shock wave therapy on chronic tennis elbow. J. Bone Joint Surg. 1996a; 78B:233–237. Rompe JD, Hopf C, Nafe B, Buerger R. Low-energy extracorporeal shock wave therapy for painful heel. Arch. Orthop. Trauma Surg. 1996b; 115:75–79. Rompe JD, Eysel P, Hopf C, Vogel J, Küllmer K. Extra- korporale Stoßwellenapplikation bei gestörter Knochenheilung. Eine kritische Bestandsauf- nahme. Unfallchirurg 1997; 100:845–849. Rompe JD, Kirkpatrick CJ, Küllmer K, Schwitalle M, Krischek O. Dose-related effects of shock waves on rabbit tendo Achillis. A sonographic and histologi- cal study. J. Bone Joint Surg. 1998a; 80B:546–552. Rompe JD, Bürger R, Hopf C, Eysel P. Shoulder func- tion after extracorporeal shock wave therapy for calcific tendinitis. J. Shoulder Elbow Surg. 1998b; 7:505–509. Rompe JD, Zoellner J, Nafe B. Bedeutung der Kalkde- potelimination bei Tendinosis calcarea der Schul- ter. Z. Orthop. Ihre Grenzgeb. 2000; 138:335–339. Rompe JD, Riedel C, Betz U, Fink C. Chronic lateral epicondylitis of the elbow (tennis elbow) – Pro- spective comparison of low-energy shock wave therapywithlow-energyshockwavetherapyplus manual therapy of the cervical spine. Arch. Phys. Med. Rehabil. 2001a; 82:578–582. RompeJD,ZöllnerJ,NafeB.Shockwavetherapyver- sus conventional surgery in the treatment of calci- fying tendinitis of the shoulder. Clin. Orthop. 2001b; 387:72–82. Rompe JD, Rosendahl T, Schöllner C, Theis C. High- energy extracorporeal shock wave treatment of nonunions. Clin. Orthop. 2001c; 387:102–111. Rompe JD, Schoellner C, Nafe B. Evaluation of low energy extracorporeal shock wave application and treatment in chronic plantar fasciitis. J. Bone Joint Surg 2002; 84-A: in press. Rosenthal RK, Folkman J, Glowacki J. Demineralized bone implants for non-union fractures, bone cysts, and fibrous lesions. Clin. Orthop. 1999; 364:61–69. Rosson JW, Simonis RB. Locked nailing for nonunion of the tibia. J. Bone Joint Surg. 1992; 74B:358–361. Rowe CR. Tendinitis, bursistis, impingement, snap- ping scapula, and calcific tendinitis. In: Rowe CR, ed. The Shoulder. New York: Churchill Livingstone, 1988:105–129. Rubenthaler F, Wittenberg RH. Mittelfristige Nachuntersuchungsergebnisse der operativ ver- sorgten Tendinosis calcarea des Schultergelenkes. Z. Orthop. Ihre Grenzgeb. 1997; 135:354–359. Rupp S, Seil R, Kohn D. Calcifying tendinitis of the rotator cuff. Orthopäde 2000; 29:852–867. Russo S, Briganti F, Gigliotti S, De Durante C, Peluso GF, Corrado EM. Treatment of scaphoid nonunion by lithotripsy. Lecture, 6th Congress of the Inter- national Federation of Societies for Surgery of the Hand (IFSSH), Helsinki, 1995. Sachs RA, Stone ML, Devine S. Open vs. arthroscopic acromioplasty: A prospective, randomized study. Arthroscopy 1994; 10:248–254. Schaden W. Single application of extracorporeal shock waves in 97 patients with nonunions or delayed healing fractures. Lecture, 67th Annual Meeting of the American Academy of Orthopaedic Surgeons, New Orleans, 2000. Schaden W, Fischer A, Sailler A. Extracorporeal shock wave therapy of nonunion or delayed osse- ous union. Clin. Orthop. 2001; 387:90–94. Schaub T, Schweden F, Witzsch U, el-Damanhoury H, Schild H, Thelen M. Computertomographie nach extrakorporaler Stoßwellenlithotripsie (ESWL) der Nieren. Teil III: Prospektive CT-Untersuchung bei 105 Patienten und 3-Jahres-Kontrolle bei 23 Patienten mit CT und seitengetrennter 99 mTc- MAG3-Clearance. RöFo. 1993; 158:121–126. Schelling G, Delius M, Gschwnder M, Grafe P, Gam- bihler S. Extracorporeal shock waves stimulate frog sciatic nerves indirectly via a cavitation- mediated mechanism. Biophys. J. 1994; 66:133–140. Schepsis AA, Leach RE, Gorzyca J. Plantar fasciitis. Etiology, treatment, surgical results, and review of the literature. Clin. Orthop. 1991; 266:185–96. Schleberger R, Senge T. Non-invasisve treatment of long bone pseudarthrosis by shock waves (ESWL). Arch. Orthop. Trauma Surg. 1992; 111:224–22. Schmitz C. Zellbiologische und molekularbiologis- che Untersuchungen bei Stosswellentherapie. Lec- ture, Working Group ESWT, 49th Annual Meeting of South German Orthopaedic Association, Baden- Baden, 2001. Seemann O, Rassweiler J, Chvapil M, Alken P, Drach GW. Effect of low dose shock wave energy on frac- ture healing: An experimental study. J. Endurol. 1992; 6:219–223. References76 Silcox DH III, Daftari T, Boden SD, Schimandle JH, Hutton WC, Whiteside TE. The effect of nicotine on spinal fusion. Spine 1995; 20:1549–1553. Simon JP, Stuyck J, Hoogmartens M, Fabry G. Pos- terolateral bone grafting for nonunion of the tibia. Acta Orthop. Belg. 1992; 58:308–313. Sistermann R, Katthagen BD. 5-years lithotripsy of plantar heel spur: experiences and results – a follow-up study after 36.9 months. Z. Orthop. Ihre Grenzgeb. 1998; 136:402–406. Smits GA, Jap PH, Heerschap A, Oosetrhof GO, Deb- ruyne FM, Schalken JA. Biological effects of high energy shock waves in mouse skeletal muscle: Correlation between 31P magnetic resonance spectroscopic and microscopic alterations. Ultra- sound Med. Biol. 1993; 19:399–409. Sobel E, Levitz SJ, Caselli MA. Orthoses in the treat- ment of rear foot problems. J. Am. Podiatr. Med. Assoc. 1999; 89:220–233. Spindler A, Berman A, Lucero E. Extracorporeal shock wave treatment for chronic calcific tendini- tis of the shoulder. J. Rheumatol. 1998; 25:1161–1163. Steinborn M, Heuck A, Maier M, Schnarkowski P, ScheidlerJ,ReiserM.MRIofplantarfasciitis.RoFo. Fortschr. Geb. Rontgenstr. Neuen Bildgeb. Verfahr. 1999; 170:41–46. Sutter M. Wesen, Klinik und Bedeutung spondyloge- ner Reflexsyndrome. Schweiz. Rdsch. Med. Praxis 1995; 42:1341–1357. Taylor JC. Delayed union and nonunion of fractures. In: Crenshaw AH, ed. Campbell’s Operative Ortho- paedics. Vol. 2. St. Louis: CV Mosby; 1992. Tillander BM, Norlin RO. Change of calcifications after subacromial decompression. J. Shoulder Elbow Surg. 1998; 7:213–217. Tomczak RL, Haverstock BD. A retrospective compar- ison of endoscopic plantar fasciotomy to open plantar fasciotomy with heel spur resection for chronic plantar fasciitis/heel spur syndrome. J. Foot Ankle Surg. 1995; 34:305–311. Tsironis K, Burger C, Meurer A, Helbig K, Becker U Rehm KE. Long-term results of extracorporeal shock wave therapy in insertion tendinitis of the shoulder, elbow and heel. Orthop. Praxis 1997; 33:669–672. Ueberle F. Shock wave technology. In: Siebert W, Buch M, eds. Extracorporeal shock waves in ortho- paedics. Berlin: Springer; 1997:59–87. Uhthoff HK, Loehr JF. Calcifying tendinitis. In: Rock- wood A, Matsen FA, eds. The shoulder. Philadepl- phia: Saunders; 1998:989–1008. Valchanou VD, Michailov P. High energy shock waves in the treatment of delayed and nonunion of fractures. Int. Orthop. 1991; 15:181–184. VaterleinN,LuessenhopS,HahnM,DellingG,Meiss AL. The effect of extracorporeal shock waves on joint cartialge – an in vivo study in rabbits. Arch. Orthop. Trauma. Surg. 2001; 120:403–406. Vebostad A. Calcific tendinitis in the shoulder region. Acta Orthop. Scand. 1975; 46:205–210. Verhaar J, Walenkamp G, Kester A, van Mameren H, van der Linden T. Lateral extensor release for ten- nis elbow. A prospective long-term follow-up study. J. Bone Joint Surg. 1993; 75A:1034–1043. Verhaar JAN, Walenkamp GHIM, van Mamaren H, Kester ADM, Van Der Linden AJ. Local corticoste- roid injection versus cyriax-type physiotherapy for tennis elbow. J. Bone Joint Surg. 1996; 78B:128–132. Vicenzino B, Collins D, Wright A. The initial effects of a cervical spine manipulative physiotherapy treat- ment on the pain and dysfunction of lateral epi- condylalgia. Pain 1996; 68:69–74. Vogel J, Rompe, JD, Hopf C, Heine J. Application of extracorporeal shock waves in the treatment of pseudoarthrosis of the lower extremity. Prelimi- nary results. Arch. Orthop. Trauma Surg. 1997; 116:480–483. vom Dorp G, Pettrone F, Boatright J, Covall D. Ran- domized clinical study to evaluate the safety and efficacy of the Siemens Sonocur ESWT System in treating patients with lateral epicondylitis (chronic tennis elbow). Personal communication, 2001. Wagenhäuser JF. Die Periarthropathie-Syndrome. Therapiewoche 1972; 37:3187–3192. Wagner KL, Sharkey PF. The use of night splints for treatment of recalcitrant plantar fasciitis. Foot Ankle. 1991; 12:135–137. Wainner RS, Hasz M. Management of acute calcific tendinitis of the shoulder. J. Orthop. Sports Phys. Ther. 1998; 27:231–237. WaldisMF.G.Hohmann’soperationontheelbow– surgical treatment of a symptom. Z. Orthop. Ihre Grenzgeb. 1989; 127:606–610. Wang C. Treatment of fracture non-union with shock wave application. Lecture, 2nd International Congress of the European Society for Musculo- skeletal Shock Wave Therapy, London, 1999. Wang CJ, Chen HS, Chen WS, Chen LM. Treatment of painful heels using extracorporeal shock wave. J. Formos. Med. Assoc. 2000; 99:580–583. Wang CJ, Chen HS, Chen CE, Yang KD. Treatment of long bone fractures with shock waves. Clin. Orthop. 2001; 387:95–101. Wang SJ, Lewallen DG, Bolander ME, Chao EYS, Ilst- rup DM, Greenleaf JF. Low intensity ultrasound treatment increases strength in a rat femoral frac- ture model. J. Orthop. Res. 1994; 12:40–47. Wanivenhaus A. Differential diagnosis of epicondyli- tis humeri radialis. Z. Orthop. Ihre Grenzgeb. 1986; 124:775–779. Warren SB, Brooker AF. Intramedullary nailing of tib- ial nonunions. Clin. Orthop. 1992; 285:236–243. Ward WG, Clippinger FW. Proximal medial longitu- dinal arch incision for plantar fascia release. Foot Ankle 1987; 8:152–155. References 77 Wehner HD, Sellier K. Compound action potentials in the peripheral nerve induced by shock waves. Acta Chir. Scand. Suppl. 1982; 508:179–184. Weise K, Winter E. Die Rolle des Marknagels bei Pseudarthrosen und Fehlstellungen. Orthopäde 1996; 25:247–258. Wess O, Ueberle F, Dührßen RN, Hilcken D, Krauß W, Reuner T, Schultheiß R, Staudenraus I, Rattner M, Haaks W, Granz B. Working group technical devel- opments – consensus report. In: Chaussy C, Eisen- berger F, Jocham D, Wilbert D, eds. High energy shock waves in medicine. Stuttgart: Thieme; 1997:59–71. Wirsching RP, Eich W, Misselbeck E. Langzeitergeb- nisse nach extrakorporaler Stoßwellentherapie bei Pseudarthrosen. Stosswelle 1998; 1:22–26. Wiss DA, Stetson WB. Nonunion of the tibia treated with a reamed intramedullary nail. J. Orthop. Trauma. 1994; 8:189–194. WirthCJ,KohnD,MelzerC,MarklA.Wertigkeit diagnostischer Maßnahmen bei Weichteilerkran- kungen und Weichteilschäden des Schulterge- lenks. Unfallchirurg 1990; 93:339–345. Wolf T, Breitenfelder J. First experiences with extra- corporeal shock wave therapy in localized pain conditions of the locomotor apparatus. Orthop. Praxis 1996; 32:480–483. Wolff JM, Mattelaer P, Boeckmann W, Kraemer U, Jakse G. Evaluation of possible tissue damage in patients undergoing extracorporeal shock wave lithotripsy employing C-reactive protein. Scand. J. Urol. Nephrol. 1997; 31:31–34. Woolnough J. Tennis heel. Med. J. Aus. 1954; 2:857–861. Wright A, Thurnwald P, O’Callaghan J. Hyperalgesia in tennis elbow patients. J. Musculoskeletal Pain 1994; 2:83–96. Wu CC, Shih CH, Chen W.J. Nonunion and shortening after femoral fracture treated with one-stage lengthening using locked nailing technique. Good results in 48/51 patients. Acta Orthop. Scand. 1999a; 70:33–36. Wu CC, Shih CH, Chen WJ, Tai CL. High success rate with exchange nailing to treat a tibial shaft aseptic non-union. J. Orthop. Trauma 1999b; 13:274. Wyke BD. Neurology of the cervical spinal joints. Physiotherapy 1979; 65:72–76. Xavier CAM, Duarte LR. Treatment of non-unions by ultrasound stimulation: first clinical applications. Lecture AAOS, San Francisco, 1987. Yeaman LD, Jerome CP, McCullough DL. Effects of shock waves on the structure and growth of the immature rat epiphysis. J. Urol. 1989; 141:670–674. Young BR. Roentgen treatment for bursitis of the shoulder. Am. J. Roentgenol. 1946; 56:626–630. Young CC, Rutherford DS, Niedfeldt MW. Treatment of plantar fasciitis. Am Fam Physician. 2001; 63:467–474. Younger EM, Chapman MW. Morbidity at bone graft donor sites. J. Orthop. Trauma 1989; 3:192–195. References78 . shock waves in ortho- paedics. Berlin: Springer; 199 7: 59 87. Uhthoff HK, Loehr JF. Calcifying tendinitis. In: Rock- wood A, Matsen FA, eds. The shoulder. Philadepl- phia: Saunders; 199 8 :98 9–1008. Valchanou. Ultra- sound Med. Biol. 199 3; 19: 399 –4 09. Sobel E, Levitz SJ, Caselli MA. Orthoses in the treat- ment of rear foot problems. J. Am. Podiatr. Med. Assoc. 199 9; 89: 220–233. Spindler A, Berman A, Lucero. lesions. Clin. Orthop. 199 9; 364:61– 69. Rosson JW, Simonis RB. Locked nailing for nonunion of the tibia. J. Bone Joint Surg. 199 2; 74B:358–361. Rowe CR. Tendinitis, bursistis, impingement, snap- ping