[Personal experience with the use of the Herbert screw in orthopedics and traumatology]

The authors present in the submitted paper their initial experience as well as theoretical possibilities of using Herbert's screw. This is a relatively new type of implant developed originally for stable compressive osteosynthesis of small bones. This screw is made from a titanium alloy in sizes of 16-32 mm and is based on the principle of traction screws. It has, however, compared with the latter some advantages and thus makes a reduction of the period of postoperative fixation possible. It is supplied along with the insertion instruments which facilitate peroperative reposition and retention of fragments for easier insertion of the screw. In the authors' department this screw was used in 1988-1991 for osteosynthesis in 18 patients incl. 12 with fractures of the navicular bone, head of the radius, the patella, Bennett's fracture, osteochondral fractures of the femoral condyle and it was also used for osteosynthesis of scapholunatal desis and desis of the interphalangeal articulations of the hand. In the authors' so far not very numerous group Herbert's screw proved useful--only in one patient the X-ray and clinical finding was not satisfactory and called for further surgical operation. It is, of course, essential to respect the surgical principles for its application, in particular in fractures of the navicular bone. The implant is an advance in the treatment of selected recent injuries as well as their late sequelae.