Lohmann H, Buck-Gramcko D
Abteilung für Handchirurgie und Plastische Chirurgie, Berufsgenossenschaftlichen Unfallkrankenhauses Hamburg.
Handchir Mikrochir Plast Chir. 1987 Nov;19(6):299-301.
The management of non-union of the scaphoid with a Herbert screw assumes a specific size of the proximal pole fragment. In cases of extremely small proximal pole fragments the length of the leading thread of the screw can cause blockage of the proximal pole fragment. In these instances a dorsal approach is used and the Herbert screw is inserted in a proximal-to-distal direction rather than the usual distal-to-proximal insertion. The advantages are a stable internal fixation and an abbreviated period of immobilization in plaster; however, the small number of cases reported does not permit us to draw conclusions regarding indications for use of this technique.
使用Herbert螺钉治疗舟骨不愈合时，近端骨块有特定大小要求。在近端骨块极小的情况下，螺钉导程长度可能导致近端骨块受阻。在这些病例中，采用背侧入路，Herbert螺钉由近端向远端插入，而非通常的由远端向近端插入。其优点是内固定稳定，石膏固定时间缩短；然而，所报道的病例数量较少，无法让我们就该技术的使用指征得出结论。
