Abstract des Autors

A unique design feature of the Herbert screw is threading of different pitch at either end of an intervening smooth shaft. The screw is cannulated to facilitate positioning over a K-wire by minimal invasive means and it does not have a protrusive head. The Herbert/Whipple screw is now available in 4.5 mm and 6.5 mm diameter. From November 1992 to December 1996 we performed 71 implantations in 65 patients. The youngest patient was 18 years old and the oldest patient was 87 (mean age = 46.6 years). 23 of them were female and 42 were male. 21 of them (= 32%) had a sports injury in their history. We performed fracture management with this osteosynthesis in humeral neck fractures, olecranon fractures and fractures of the distal radius as well as tibial head fractures, fractures of the Volkman's triangle, medial malleolar fractures and Jones fractures. Bony healing occurred in 93% of the cases. No non-union, no infection, no broken screws. We had to redo conventional reosteosynthesis in 5 cases due to early screw or fracture displacement. Referring to our data we believe that the Herbert/Whipple screw satisfies the requirements of a bio"logical" osteosynthesis. The insertion by minimal invasive means allows early recoverage of function and weight-bearing. This early rehabilitation could also be of use in sports medicine. Verf.-Referat