Abstract: Abstract: Objective To investigate the efficacy of extracorporeal shock wave therapy (ESWT) combined with hyperbaric oxygen for treatment of long-bone fracture nonunion. Methods Sixty cases of long bone fracture nonunion in our hospital were used as study subjects. They were divided into three groups by random number table method. Group A was treated by ESWT，group B was treated by ESWT combined with hyperbaric oxygen and group C was treated by surgery. All patients were followed up 12 months at least. Then the healing rate (6, 9 and 12 months), bone densities (6, 12 and 24 weeks), alkaline phosphatase (ALP, 1, 2, 3, 4, and 6 weeks) and complications were observed in three groups of patients. Results All patients had no long-term complications, and the skin complications were less in group B than those in group A and C. There were no significant differences in the effective rates and ALP levels at different time points after treatment between group B and C, and which were better than those of group A (P＜0.05). The ALP levels were higher at different time points after treatment than those before treatment in three groups, and the overall trend was increased with time (P＜0.05). The bone densities at different time points were higher after treatment in group B than those of group A(P＜0.05). The bone mineral densities at each time point were higher in group A and group B than those before treatment, and the overall trend was increased with time (P＜0.05). Conclusion ESWT combined with hyperbaric oxygen for treatment of long-bone fracture nonunion is safe, effective and have a fewer skin complications.

Key words: hyperbaric oxygenation, extracorporeal shock wave therapy, nonunion