〔Abstract〕 Objective To explore effects of extracorporeal shock wave(ESW) combined with platelet rich plasma(PRP) on bone healing in rats with osteoporotic fracture.Methods Osteoporosis rat models were established by ovariosteresis(OVX). 50 female 3 months old SD rats were randomly divided into control group(Control), OVX group, OVX+ESW group, OVX+PRP group and OVX+ESW+PRP group, 10 cases in each group. In Control group, the same amount of ovarian surrounding tissue was excised. The right femur fracture was conducted on rats in the above groups, and the rats were given intramedullary fixation with Kirschner wire. The effects of ESW combined with PRP on bone healing in rats with osteoporotic fracture were observed. And the action mechanism was explored.Results After OVX, bone mineral density of rats was(0.22±0.07)g/cm2and significantly lower than that in Control group(P<0.05). Imaging showed that fracture line was clear in OVX+ESW+PRP group, there were large number of bone callus tissues formation, and fracture healing was better than that in OVX+ESW group and OVX+PRP group. HE staining showed that after treatment, bone trabecula was thicker and its number got more in OVX+ESW+PRP group. And arrangement was orderly, histopathological improvement was better than that in OVX+ESW group and the OVX+PRP group. After OVX rats were treated with ESW and PRP, in maximum load at fracture site,the expression of bone morphogenetic protein-2( BPM-2),runt-related transcription factor 2(RUNX2) and zinc finger transcription factor(OSX) in bone callus tissue increased,while the levels of serum bone alkaline phosphatase( BALP),bone gla protein( BGP) and procollagen type Ⅰ carboxy-terminal peptide(PICP) decreased(P<0. 05). And the effect was better than that in OVX + ESW group and OVX + PRP group.Conclusion ESW combined with PRP can promote bone healing in rats with osteoporotic fracture,which may be related to down-regulation of BALP,BGP and PICP levels,and up-regulation of BPM-2,RUNX2 and OSX expression.