Martini A K, Schiltenwolf M
Sektion Handchirurgie, Orthopädischen Universitätsklinik Heidelberg.
Aktuelle Traumatol. 1993 Nov;23(7):317-23.
The Herbert screw is a self-cutting headless screw that is designed to effect interfragmentary compression on being screwed in and is suitable for scaphoid surgery besides being useful also for other purposes. Although the Herbert screw is biomechanically inferior in many respects to the spongiosa screw, prognosis is impressively improved in scaphoid surgery (in pseudarthroses and fractures) by implanting the Herbert screw. It replaces the Matti-Russi plasty and is used in proximal, dislocated medium-positioned and unstable fractures. 73 scaphoid pseudarthroses and 27 fractures were treated with the Herbert screw between 1989 and 1991 at the Dept. of Orthopaedics at the University of Heidelberg. In 46% of problematic indications successful healing was achieved in more than 90% of the cases. However, surgical technique is complicated, requiring a certain amount of practice to keep iatrogenic traumatisations as low as possible. In the treatment of pseudarthroses special attention must be paid to careful and extensive sclerosis resection. Although the Herbert screw is screwed in through the articular surface, the procedure does not necessarily imply an accelerated development of arthrosis.
赫伯特螺钉是一种自攻无头螺钉，设计用于旋入时实现骨折块间加压，除其他用途外，适用于舟骨手术。尽管赫伯特螺钉在许多方面生物力学性能不如松质骨螺钉，但在舟骨手术（假关节和骨折）中，通过植入赫伯特螺钉，预后有显著改善。它取代了马蒂 - 鲁西成形术，用于近端、脱位的中位和不稳定骨折。1989年至1991年期间，海德堡大学骨科用赫伯特螺钉治疗了73例舟骨假关节和27例骨折。在46%的疑难病例中，超过90%的病例实现了成功愈合。然而，手术技术复杂，需要一定的实践经验以尽可能降低医源性创伤。在假关节治疗中，必须特别注意仔细和广泛地切除硬化组织。尽管赫伯特螺钉是通过关节面旋入的，但该手术并不一定会加速关节病的发展。
