Tumilty J A, Squire D S
Memorial University of Newfoundland, St. John's, Canada.
J Hand Surg Am. 1996 Jan;21(1):66-8. doi: 10.1016/S0363-5023(96)80155-9.
The Herbert bone screw as developed by T. Herbert in the early 1980s has been used in the treatment of scaphoid fractures and nonunions. Reports on clinical efficacy have been accompanied by discussions of technical difficulties. This study determines if the curvilinear surface of the proximal pole of the scaphoid leads to errors in screw length and penetration into the joint. The screw was inserted in cadaveric wrists using the technique described by Herbert. Plain x-ray films were taken in the anteroposterior and lateral planes and fluoroscopy was used through 360 degrees. From the imaging studies, we decided whether subchondral penetration of the screw had occurred. The scaphoids were then dissected and the dorsal poles inspected. In our six specimens, two screws were found to be penetrating subchondral bone. The plain x-ray films were accurate in five of six specimens. Fluoroscopy was accurate in all six. Fluoroscopy during placement of the Herbert screw may decrease the rate of subchondral penetration.
20世纪80年代初由T. 赫伯特研发的赫伯特骨螺钉已用于舟骨骨折和骨不连的治疗。关于临床疗效的报告伴随着对技术难题的讨论。本研究确定舟骨近端极的曲线表面是否会导致螺钉长度误差以及穿入关节。采用赫伯特描述的技术将螺钉插入尸体手腕。在前后位和侧位拍摄普通X线片，并进行360度透视。根据影像学研究，我们判断螺钉是否发生了软骨下穿透。然后解剖舟骨并检查背侧极。在我们的6个标本中，发现2枚螺钉穿透了软骨下骨。普通X线片在6个标本中的5个是准确的。透视在所有6个标本中都是准确的。放置赫伯特螺钉时进行透视可能会降低软骨下穿透的发生率。
