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Related Experiment Videos

[Experiences with the Herbert screw]

A K Martini1

  • 1Sektion Handchirurgie, Universität Heidelberg.

Handchirurgie, Mikrochirurgie, Plastische Chirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Handchirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Mikrochirurgie Der Peripheren Nerven Und Gefasse : Organ Der V
|July 1, 1993
PubMed
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Matti-Russe grafting with Herbert screw fixation effectively treats scaphoid non-unions and fractures. This surgical approach offers good healing rates and faster rehabilitation, even in complex cases.

Area of Science:

  • Orthopedic Surgery
  • Hand Surgery
  • Traumatology

Background:

  • Scaphoid non-union presents challenges, particularly in old, recurrent, or proximal fragment cases.
  • Traditional Matti-Russe grafting can be problematic in complex scaphoid non-union scenarios.
  • Early surgical intervention for proximal scaphoid fractures improves healing and reduces immobilization time.

Purpose of the Study:

  • To evaluate the efficacy of Matti-Russe grafting combined with Herbert screw fixation for scaphoid non-unions and fractures.
  • To assess outcomes in problematical cases, including old/recurrent non-unions and proximal fractures.
  • To determine the impact of this combined technique on healing, stability, and rehabilitation.

Main Methods:

  • Surgical treatment of 34 scaphoid non-unions and 12 fractures using Matti-Russe grafting and Herbert screw stabilization.

Related Experiment Videos

  • Short-term plaster-cast immobilization (2-3 weeks for fractures, 4-6 weeks for non-unions).
  • Modification of the reposition jig to address STT-joint subluxation during surgery.

    • Main Results:

    • High primary healing rates for scaphoid fractures (all cases).
    • Successful stabilization of non-union fragments with the Herbert screw, even without complete consolidation in two cases.
    • Favorable wrist mobility and shortened rehabilitation periods due to limited immobilization.

    Conclusions:

    • Matti-Russe grafting with Herbert screw fixation is an effective treatment for scaphoid non-unions and fractures, especially complex cases.
    • The technique promotes good healing and stability, with benefits for wrist function and patient recovery.
    • Surgical modifications may be necessary to mitigate complications like STT-joint subluxation.