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Peer-reviewedCC BY 4.0Wiener Medizinische Wochenschrift (1946)

Extracorporeal shockwave therapy as a key component of interdisciplinary wound management in diabetic foot syndrome

  • Richard Crevenna1,2,3
  • Zoltan Vass4
  • Michael Mickel1,2
  • Michael Leutner5
  • Shuren Li6
  • Mohammad Keilani1,2,3
6 affiliations
  1. 1Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, University Hospital General Hospital Vienna, Vienna Healthcare Group, Vienna, Austria
  2. 2Comprehensive Center for Musculoskeletal Disorders (CCMSD), Medical University of Vienna, University Hospital General Hospital Vienna, Vienna Healthcare Group, Vienna, Austria
  3. 3Competence Center for Occupational Safety and Health Promotion, University Hospital General Hospital Vienna, Vienna Healthcare Group, Vienna, Austria
  4. 4Department of Internal Medicine I, Infectiology, Medical University of Vienna, University Hospital General Hospital Vienna, Vienna Healthcare Group, Vienna, Austria
  5. 5Department of Internal Medicine III, Endocrinology and Metabolism, Medical University of Vienna, University Hospital General Hospital Vienna, Vienna Healthcare Group, Vienna, Austria
  6. 6Department of Radiology and Nuclear Medicine, Clinical Division of Endocrinology & Metabolism, Medical University of Vienna, University Hospital General Hospital Vienna, Vienna Healthcare Group, Vienna, Austria
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Abstract

Background: A 57-year-old male patient presented with the first manifestation of severe type 2 diabetes mellitus in the setting of diabetic foot syndrome complicated by osteomyelitis.

Methods: The patient was treated conservatively within a multimodal interdisciplinary approach. In addition, focused extracorporeal shockwave therapy (fESWT) was performed according to International Society for Medical Shockwave Treatment (ISMST)-oriented principles.

Results: After five sessions of fESWT, local wound management resulted in extraction of a relevant bony sequestrum. Following sequestrum removal, a large wound cavity remained in the region of the right first toe (digitus I pedis), corresponding approximately to the size of an entire phalanx. Remarkably, within only 4 days, rapid and substantial granulation of the deep wound cavity was observed.

Conclusion: The present case supports the hypothesis that focused ESWT may represent a clinically relevant adjunctive treatment option in selected patients with diabetic foot syndrome and complicated wound healing disorders. At the same time, it highlights the need for prospective randomized controlled trials.

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Cite

BibTeXRIS
BibTeX
@article{crevenna2026extracorporeal,
  title = {{Extracorporeal shockwave therapy as a key component of interdisciplinary wound management in diabetic foot syndrome}},
  author = {Richard Crevenna and Zoltan Vass and Michael Mickel and Michael Leutner and Shuren Li and Mohammad Keilani},
  journal = {Wiener Medizinische Wochenschrift (1946)},
  year = {2026},
  month = aug,
  doi = {10.1007/s10354-026-01184-1},
  url = {https://doi.org/10.1007/s10354-026-01184-1},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Extracorporeal shockwave therapy as a key component of interdisciplinary wound management in diabetic foot syndrome
AU  - Richard Crevenna
AU  - Zoltan Vass
AU  - Michael Mickel
AU  - Michael Leutner
AU  - Shuren Li
AU  - Mohammad Keilani
PY  - 2026
DA  - 2026/08/17
JO  - Wiener Medizinische Wochenschrift (1946)
DO  - 10.1007/s10354-026-01184-1
UR  - https://doi.org/10.1007/s10354-026-01184-1
AB  - Background: A 57-year-old male patient presented with the first manifestation of severe type 2 diabetes mellitus in the setting of diabetic foot syndrome complicated by osteomyelitis.  Methods: The patient was treated conservatively within a multimodal interdisciplinary approach. In addition, focused extracorporeal shockwave therapy (fESWT) was performed according to International Society for Medical Shockwave Treatment (ISMST)-oriented principles.  Results: After five sessions of fESWT, local wound management resulted in extraction of a relevant bony sequestrum. Following sequestrum removal, a large wound cavity remained in the region of the right first toe (digitus I pedis), corresponding approximately to the size of an entire phalanx. Remarkably, within only 4 days, rapid and substantial granulation of the deep wound cavity was observed.  Conclusion: The present case supports the hypothesis that focused ESWT may represent a clinically relevant adjunctive treatment option in selected patients with diabetic foot syndrome and complicated wound healing disorders. At the same time, it highlights the need for prospective randomized controlled trials.
SN  - 0043-5341
SN  - 1563-258X
ER  -