2025, Vol. 7, Issue 2, Part D
Focused Extracorporeal Shockwave Therapy Promotes Healing in Chronic Midfoot Fractures of Charcot Neuro-Osteoarthropathy: A Case Report
Author(s): Sneha Sathe and Christopher Lu
Abstract: Background: harcot neuro-osteoarthropathy (CNO) causes midfoot fractures, deformity, profound sensory loss and elevated amputation risk, placing a substantial economic burden on the Canadian healthcare system (~$547M/year for diabetic foot complications).
Case Presentation: A 44-year-old man with a two-year history of insensate, non-healing 2nd/3rd tarsometatarsal fractures (Eichenholtz Stage 3) underwent five weekly sessions of focused extracorporeal shockwave therapy (Chattanooga Intelect focused shockwave device; 0.3 mJ/mm², 3,000 shocks per session, 4 Hz). The treatment targeted the nonunion site and the sural nerve region (0.12 mJ/mm² for nerve-targeted applications). No analgesia was administered. Sessions 1–2 produced no intra-treatment sensation; Session 3 produced mild tingling, with progressive sensory perception during Sessions 4–5.
Outcome: By 2 months there was callus formation, girth decreased from 32 to 26 cm, VAS fell from 8/10 to 2/10, AOFAS improved from 35/90 to 62/90, and protective sensation improved to 4/10 sites. At 6 months the patient was pain-free, cast-free, hiking (5 km/week) with 7/10 protective sensation and AOFAS 85/90; the planned amputation was cancelled. At 12 months the patient continued pain-free, with sustained sensory gains and full return to work. No adverse events occurred.
Conclusion: Focused ESWT may produce concurrent bone healing and intra-treatment neurosensory recovery in chronic Charcot nonunion. These dual effects warrant validation in larger, controlled trials and could offer a noninvasive limb-salvage option that reduces the individual and system costs of diabetic foot complications.
DOI: 10.22271/27078345.2025.v7.i2d.286Pages: 208-210 | Views: 117 | Downloads: 57Download Full Article: Click Here
How to cite this article:
Sneha Sathe, Christopher Lu.
Focused Extracorporeal Shockwave Therapy Promotes Healing in Chronic Midfoot Fractures of Charcot Neuro-Osteoarthropathy: A Case Report. Int J Case Rep Orthop 2025;7(2):208-210. DOI:
10.22271/27078345.2025.v7.i2d.286
