Journal of Musculoskeletal Trauma

HERBERT SCREW FIXATION FOR NON-COMMINUTED CLOSED MEDIAL MALLEOLAR FRACTURE: Dong Man Park, Yong Jin Kim, Jea Won Chang, Jin Cheul Park; J Korean Soc Fract 1999;12(3):638-644. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.638

Abstract PDF: It is known that the Salter-Harris type I and II fractures of the distal tibial epiphysis usually Non-comminuted closed displaced medial malleolar fracture has been treated by open reduction and internal fixation. Since fracture fragment of medial malleolar is usually thiner and smaller than that of lateral malleolar, it is more difficult to fix firmly than that of lateral malleolar. In the treatment of medial malleolar fracture, although various fixation methods in the treatment of medial malleolar fracture have been reported, several complications have been reported. And then authors have been tried to find fixation methods and firm fixation material for medial malleolar fracture to minimize complications. The purpose of this paper is to compare operation time, duration of bone union, the presence of complication, and results by Meyer and Kumler criteria between Herbert and malleolar screw and to introduce percutaneous Herbert screw fixation technique. Since March 1996, forty-four patients had undergone surgical intervention for medial malleolar fractures. Twenty-three Herbert screw and twenty-one malleolar screws were used. The results were as follows; The operation time was shorter in Herbert screw fixation group. There were no complications such as pain and tenderness due to hardware protrusion and metal lossening in Herbert screw fixation group. We come to the coonclusion that the Herbert screw fixation method was a little better than the malleolar screw fixation method according to comparison by Meyer and Kumler ctireria. We concluded that Herbert screw fixation was a better method for non-comminuted closed displaced medial malleolar fracture to obtain early union and to prevent postoperative complications.

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The Operative Treatment of Displaced Waist Fracture of Scaphoid: Kun Yung Lee, Young Kee Lee, Yong Man Cho, Heung Sik Kang, Cheon Dong Lee, Sang Su Oh; J Korean Soc Fract 1997;10(1):164-170. Published online January 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.1.164

Abstract PDF: The authors surveyed the clinical study of 17 cases of scaphoid fractures from March 1989 to September 1994 with minimal 1 year follow up at Department of Orthopedic Surgery, Lee-Rha general Hospital. The following conclusions were obtained through clinical survey. 1. Of all 17 cases, they were 13 males and 4 females; Among the 13 males, 10 cases were aged between 20 and 39 years, forming 58.8% of all. 2. All 17 cases were treated by open reduction. Unions were obtained at average 11.5 weeks in 7 cases treated with Herbert screw fixation and 12 weeks in 10 cases treated with K-wire fixation. 3. Two of ten K-wire treated cases resulted in delayed union, one of seven Herbert screw treated cases resulted in delayed union. 4. Unions were obtained at average 20 weeks in 3 cases of delayed union. We concluded that open reduction and K-wire fixation were recomanded for the compatible treatment method of displaced waist fracture of scaphoid.

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A Clinical Study of the Intra-articular Fracture of the Elbow Joint Fixed with Herbert Sciew: Won Sik Choy, Hyun Dae Shin, Whan Jeung Kim, Kwang Won Lee, Hyun Jong Park, Yoo In Kim; J Korean Soc Fract 1996;9(4):1111-1117. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.1111

Abstract PDF: The intra-anicular fracture of the elbow joint can render the elbow joint unstable. In this situation. it is desired to reduce and fix the bone fragment internally. The goal of treatment of the intra-aficular fracture of the elbow joint is a painless, stable elbow to provide a favorable range of motion. Fourteen patients of the intra-articular fraciure of the elbow joint who were treated with Herbert screw in Eul Ji General Hospital, Taejon from October, 1993 to December, 1994. were analyzed in clinical and radiologic aspects. The results obiained from this study were as follows; 1. Among 74 patients, male were 11 cases(78.5%) and female were 3 cases(21.5%). 2. The average age of patients were 31.8 years with range from 15 years to 11 years and the follow-up period ranged from 16 months to 33 months with average 19.6 months. 3. The most common cause of injury was fall down(50.0%) followed by slip down(28.5%) and traffic acrident(21.5%). 4. The most common intra-articular frarture of the elbow joint was capitellum fracture(50.0%) rollowed by radial head fracture(35.6%). 5. Through late radiologic assessment, there was 1 case of post-traumatic arthritis. 6. The result of treatment were excellent in 6 patients(42.8%), good in 1 patients(50.0%) fair in 1 patient(7.2%) by functional rating index of Morrey.

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Surgical Treatment of Scaphoid Nonunion: Jae Ik Thim, Taek Sun Kim, Sung Jong Lee, Suk Ha Lee, Chang Moo Yoo, Kil Joo Han; J Korean Soc Fract 1996;9(1):15-23. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.15

Abstract PDF

The scaphoid fracture is the most common fracture of the carpal bone in young men and has high incidence of nonunion. Many methods of treatment for nonunion of the carpal scaphoid have been described; bone grafting, screw fixation, pulsed electromagnetic field and cast, percutaneous pinning and Herbert screw fixation. Two of the commonest methods of treatment are Matti-Russe procedure and Herbert screw fixation and this paper compares these two surgical treatments. At the Department of Orthopaedic Surgery, Korea Veterans Hospital, from October 1988 to October 1994, 11 cases of the scaphoid nonunion had been treated by Matti-Russe procedure only (4 cases), Matti-Russe procedure with K-wire (2 cases) and Bone graft with Herbert screw fixation (5 cases) and followed up more than 1 year. The results were as follows; 1. Among 11 cases, 10 cases were male and 1 case was female and the range of age was 19-46 years (Mean 26.2 years). 2. The sites of fracture were confined to the waist in 9 cases (82%) and prox 1/3 in 2 cases (18%). 3. The treatment methods were Matti-Russe only in 4 cases, Matti-Russe procedure with K-wire in 2 cases and Bone graft with Herbert screw fixation in 5 cases. 4. Postoperative cast immobilization was done for 16.5 weeks in the cases treated by Matti-Russe procedure and for 4 weeks in the cases treated by Bone graft with Herbert screw fixation. 5. The union rate was 91 % after postoperative 4 months (Mean 4.1 months). 6. The results of treatment were excellent in 7 cases (64%), good in 3 cases (27%) and fair in 1 case(9%). Therefore the Matti-Russe procedure and Bone graft with Herbert Screw fixation are good procedures in the treatment of scaphoid nonunion. But, Bone graft with Herbert screw fixation is more useful in young men because of short periods of immobilization and early returning to work.

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Volar Percutaneous Cannulated Screw Fixation for Subacute Scaphoid Wasit Fracture
Jae Kwang Kim, Jong Oh Kim, Seung Yup Lee, Nam Hoon Do
Journal of the Korean Fracture Society.2009; 22(2): 104. CrossRef

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Management of the Intraarticular and Periarticular Fracture Using a Herbert bone screw: Clinical analysis of Technical Probleus of Surgery and Complications: In Kim, Young Kyun Woo, Ju Hae Chang, Yong Sik Kim, Seok Whan Song, Soon Yong Kwon, Whan Kun Yoo; J Korean Soc Fract 1995;8(1):216-227. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.216

Abstract PDF: 32 cases of intraarticular and periarticular fractures treated with the Herbert bone screw were analyzed retrospectively by radiographic and functional assessment in the department of orthopaedic surgery of Catholic University Medical College from 1989 to 1994. 1. According to the anatomical distribution, there were various fracture sites as follows: 11 cases of carpal scaphoid, 7 cases of distal humerus, 4 cases of proximal radius, 3 cases of proximal humerus, 3 cases of femoral head,2 cases of distal radius, metacarpal head and medial malleolus in each 1 case. 2. Early and late radiographic assessment showed some complications as follows: 1) Through early radiographic assessment, there were 2 cases of inaccurate reduction of fracture fragment,2 cases of inappropriate fixation (out of bone) and 1 cases of insecure fixation followed by displacement of fracture fragment. 2) Through late radiographic assessment, there were 3 cases of posttraumatic arthritis, 2 cases of avascular necrosis of the osteochondral fracture fragment ; Of 3 cases of posttraumatic arthritis, 2 cases were related to the progressive protrusion of screw head resulting from degenerative thinning of the articular cartilage. Through this study, it was stressed that 1. Fracture personality must be evaluated for the appropriate use of Herbert screw, considering the fracture pattern and sites. 2. The head including a trailing thread must be inserted into the subchondral bone to prevent the protrusion of screw head, being aware of the progressive thinning of cartilage resulting from the inevitable posttraumatic arhritis or avasculsr necrosis of fracture fragment. 3. In the cases of osteochondral fracture deserving the shear force by musculotendinous pulling and joint motion, Herbert screw seems to be undesirable. 4. The Herbert screw is effective method, but needs skill and experience if errors are to be avoided.

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A Diagnosis and Treatment of Carpal Scaphoid Fractures: Ig Gon Kim, Soo Gon Kim; J Korean Soc Fract 1994;7(2):371-378. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.371

Abstract PDF: The scaphoid fracture is the most common fracture in carpal bones. Its diagnosis is very difficult because of less symptoms and swelling. But unfortunately its complications such as nonunion, avascular necrosis, and osteoarthritis were severe. We reviewed 27 cases of the carpal scaphoid fractures treated from March 1989 to March 1993 in Hae-Dong hospital and obtained following results. 1. The highest peak was third and forth decades. 24 cases were male among 27 cases. The most common cause of fracture was outstretched hand injury. 2. The middle third was the most common location(60%) and transverse type fractures were 12 cases(75%) among these fractures. 3. We gained 75% bone union at average 15.4 weeks in proximal 1/3 carpal scaphoid fractures, 93% union at average 12.9 weeks in middle 1/3 fractures, and 100% union at average 11.2 weeks in distal 1/3 fractures. 4. The results of treatments were evaluated by Maudsley method. Excellent and good results were 10 of 11 cases in conservative treatment, 13 of 16 cases in operative treatment. According to fracture sites excellent, and good results were 1 of 4 cases in proximal fracture, 14 of 16 cases in middle fracture and all of 7 cases in distal. 5. The complications were 2 cases of nonunion,3 cases of avascular necrosis and 2 cases of osteoarthritis. 6. In case of delayed diagnosis, the longer duration of treatments were needed, We obtained better results in fresh, undisplaced fractures with thumb spica cast than old displaced fractures. We gained better results in displaced fractures with open reduction and bone graft than conservative methods.

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Herbert screw fixation of fracture of the radial head and capitellum: Ik Dong Kim, Joo Chul Ihn, Poong Taek Kim, Byung Chul Park, Young Goo Lyu, Il Hyung Park, Koo Hee Lee; J Korean Soc Fract 1991;4(2):356-361. Published online November 30, 1991; DOI: https://doi.org/10.12671/jksf.1991.4.2.356

Abstract PDF: No abstract available.

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