Herbert Screw Fixation for Minimally Displaced Fractures of the Patella

The results of treatment of patellar fractures with the Herbert Screw were reviewed retrospectively to clarify the usefulness of this screw.Three patients had open reduction and internal fixation with the screw. The other two patients were established non-unions of the patella, so they had bone-grafting with internal fixation. None of the patients required external fixation after surgery and knee exercises were encouraged as soon as possible.Three fractures healed primarily and all of these three achieved a painless knee which had a full range-of-motion. Both cases of non-union achieved a solid union clinically as well as radiologically.By using guide wires and X-ray images, this screw could be driven safely and accurately, and bone fragments could be fixed solidly. In addition, as they were buried in the bones, no irritable symptoms caused by screw heads developed after surgery and therefore removal of the screw was not required in any cases. However this screw could not be used for comminuted fractures of the patella.