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Although the primary management of fractures is highly developed in Central Europe 1% of fractures develop a non-union. After successful pilot studies the Traumacenter Meidling started in December 1998 to treat non-unions regularly with shock wave therapy. From December 1998 to August 2004, 1153 patients with non-union and delayed healing fractures were treated. The results of 755 patients are available up to September 2004. The patients consisted of 250 (33%) female and 505 (67%) male. The mean age was 44.1 years (10; 90). The mean age of the non-union was 15.5 months. In 74 (10%) osteomyelitis was present before shockwave therapy. Out of 755 non-unions 593 (79%) achieved bony healing. As expected, the subgroup of 284 delayed unions (shockwave therapy 3–6 months after the trauma or the last surgery concerning the bone) showed the best results. 245 (86%) healed. Out of 471 non-unions being older than 6 months 348 (72%) achieved bony healing. Because of the efficacy and the lack of complications as well as the economic advantage in comparison to surgery, shockwave therapy is considered as therapy of first choice in the treatment of non-union and delayed healing fractures. [ABSTRACT FROM AUTHOR]