[Conservative treatment of non-unions : Options and limitations]

Despite modern medical care, non-unions occur in 2-5% of all fractures. The burden on patients involves prolonged rehabilitation and potentially further surgery. Costs for healthcare systems increase substantially. While surgical intervention represents the standard of care, a range of non-surgical treatment options is available. A particular advantage of non-surgical treatment is the avoidance of surgery itself. Low-intensity pulsed ultrasound therapy (LIPUS) and the use of pulsed electromagnetic fields (PEMF) are painless and applied by patients themselves once daily. With focused extracorporeal shockwave therapy (ESWT), administration by a physician-usually under general anesthesia-ensures the treatment takes effect precisely at the target site. Bony defects up to 5-10 mm in size can be treated without surgery, provided there is no infection and mechanical stability is adequate.