1. Economic Aspects in Bone Healing
W. Schaden,
Trauma Center Meidling / Vienna
Ludwig Boltzmann Institute for Experimental and Clinical Traumatology

2. in seven AUVA- Trauma Centers from 2005 - 2009
ESWT for Non-Union Fractures – Economic Aspects
Diagnosis: Fractures versus Pseudarthrosis
in seven AUVA- Trauma Centers from
Dia.
2005
2006
2007
2008
2009
total
Fracture
45.077
45.580
44.940
46.079
43.073
Pseudarthrosis
1.163
1.126
1.168
1.257
992
5.706 %
2,58
2,47
2,59
2,72
2,30
2,53

3. ESWT for Non-Union Fractures – Economic Aspects
in one year in Austria (~ 8 Mio inhabitants)
~ (0,05%) fractures are reported, of which
~ develop non-unions: (2,5%)

4. University of Economics in Vienna (Studiendekan Prof. Dkfm. Dr. W
University of Economics in Vienna (Studiendekan Prof. Dkfm. Dr. W. Kemmetmüller)
first op
68%
success
non-union
cons. therapy d op
success?
second op
23%
impl.
rem.
third op 7% d
Amputation 2% d

5. ESWT for Non-Union Fractures – Economic Aspectsop
25 %
ESWT d
Success ~ 75 %
second op d
impl.
rem.
third op
amputation d

6. Shockwave Treatment of Non-Unions: Economical considerations
ESWT for Non-Union Fractures – Economic Aspects
Shockwave Treatment of Non-Unions: Economical considerations
65% - 75% (6.500 – 7.500) of the non-unions
are suitable for shock wave therapy
(~ non-unions per year).

7. Approximately Costs for non-unions treatment in Austria
ESWT for Non-Union Fractures – Economic Aspects
Approximately Costs for non-unions treatment in Austria
one op (incl. impl. rem.) € ,-
two op (incl. impl. rem.) € ,-
three op (incl. impl. rem.) € ,-
+ amputation € ,-
ESWT € ,-

8. Comparison of costs of 7.000 non-unions
ESWT for Non-Union Fractures – Economic Aspects
Comparison of costs of non-unions
one op (68%) à € ,-/ ,-
two op (23%) à € ,-/ ,-
three op ( 7%) à € ,-/ ,-
+ amput ( 2%) à € ,-/ ,-
total: ,-

9. Comparison of costs of 7.000 non-unions
ESWT for Non-Union Fractures – Economic Aspects
Comparison of costs of non-unions
ESWT (75%) à € ,-/ ,-
2. ESWT (25%) à € ,-/ ,-
not healed (25%) à € ,-/ ,-
1.750 (25%) non-unions => „standard of care“
one op (68%) à € ,-/ ,-
two op (23%) à € ,-/ ,-
three op (7%) à € ,-/ ,-
+ amputation (2%) à € ,-/ ,-
total ,-

10. ESWT for Non-Union Fractures – Economic Aspects
By treating non-unions a year with ESWT the treatment costs could be reduced as follows
€ ,-
- € ,-
€ ,- (~ 66%)
Not included are the savings due to shorter sick leave and lower insurance costs.

11. for Non-Union Treatment??
“Gold Standard”
for Non-Union Treatment??

12. How many fractures per year do you estimate do occur in an average population in %?
a, 0,1% = 1 out of
b, 0.05% = 5 out of
c, 0,01% = 1 out of
d, 0,005% = 5 out of
How many pseudarthroses (non-unions) do heal on an average after a single surgical procedure (data from social insurance)?
a, 68%
b, 78%
c, 88%
d, 98%
Austria has to deal with ~ non-unions per year. If every patient would receive ESWT instead of surgery the amount of money to be saved would be
a, €
b, €
c, €
d, €