Osteochondritis dissecans and osteochondral fragments managed by Herbert compression screw fixation.

Treatment of osteochondritis dissecans and osteochondral fragments using Herbert compression screw fixation combined with drilling gives satisfactory results. The Herbert screws may be inserted arthroscopically after identifying the lesion. The need for arthrotomy is eliminated in most instances. Management was by drilling and pinning for unseparated lesions and crater preparation with fragment fixation in cases with separated osteochondral fragments. The follow-up period is only four to 28 months. One case required arthrotomy. Ten patients with a four-month to five-year history of knee pain had unseparated lesions. Eight had excellent results with union, one required drilling and removal of sequestrae, and one remains unhealed. Three cases had separated osteochondral fragments. All three appear to have obtained union of the separated fragments without recurrence of separation.