3.5 mm Herbert Screw Specification, Uses & Sizes

3.5 mm Herbert Screws

3.5 mm Herbert Screw Specification

  • Herbert Screw has headless design, it means that the screw is completely embedded in the bone, without any protrusions to cause tissue irritation even in intra-articular placement.
  • Cannulation helps ensure precise placement of the screw.
  • The thread design of the Herbert Screw creates compression and provides fracture stability. As the proximal threads engage the bone, the fracture is drawn together, helping to create and maintain stability of the fracture site.
  • Herbert Cannulated Guide Pins hold the fragment and act as guides for drilling, tapping, and screw placement.
  • 3.5 mm Herbert Screws available lengths are 8mm, 10mm, 12mm, 14mm, 16mm, 18mm, 20mm, 22mm, 24mm, 26mm, 28mm, 30mm, 32mm, 34mm, 36mm, 38mm, 40mm, 42mm, 44mm, 46mm, 48mm, 50mm, 55mm, 60mm, 65mm, 70mm, 75mm and 80mm.
  • 3.5 mm Herbert Screw is made from pure Titanium and SS 316L.
  • Any additional length sizes of this screw will be made on demand.
  • Instruments are available for this screw such as Bone Taps, Combined Drill & Tap Sleeve, Counter Sink, Depth Gauge, Drill Bits, Drill Guide, Drill Sleeve, Hollow Mill Screw Removal, Reverse Measuring Device, Screw Drivers and Screw Holding Forceps etc.

3.5 mm Herbert Screw uses

Herbert Screw is designed for the management of fractures where minimal tissue coverage makes standard screw use inappropriate or where
extreme precision in fragment alignment is imperative. Such locations might include fractures of the:
Olecranon and malleolar region
Distal femur
Proximal tibia
Distal tibia

3.5 mm Herbert Screw is intended for fixation of intra-articular and extra-articular fractures and nonunions of small bones and small bone fragments; arthrodeses of small joint; bunionectomies and osteotomies, including scaphoid and other carpal bones, metacarpals, tarsals, metatarsals, patella, ulnar styloid, capitellum, radial head and radial styliod.

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3.5 mm Herbert Screw Surgical Technique

STEP 1: Guide Pin
After initial reduction of the fracture fragments is obtained, the specifically designed Herbert Cannulated Guide Pin is placed through the fragments to act as a Guide Wire for the rest of the placement operation. The Guide Pin should not perforate the opposite cortex.

STEP 2: Depth Gauge
Use the Depth Gauge to measure the length of the Guide Pin in the bone. If the Guide perforates the opposite cortex, corresponding compensation
must be made when selecting the implant length.

STEP 3: Proximal Drill Bit
Insert the Proximal Drill Bit over the Guide Pin to drill the cortex. The Drill Bit should be advanced until the built-in stop contacts the cortex of the bone.

STEP 4: Distal Drill Bit
Insert the Distal Drill Bit over the Guide Pin and drill to the desired depth. At this time the surgeon may choose to drill 5mm less than the
pilot length.

STEP 5: Cannulated Tap
Insert the Cannulated Tap over the Guide Pin and tap the channel to prepare for the leading screw threads of the implant. Tap depth should be equal to the depth created by the Distal Drill Bit.

STEP 6: Insert Screw
In determining screw length, the surgeon may wish to choose an implant 5mm to 10mm shorter than the measured pilot length. Using the Cannulated Screwdriver, insert the Herbert Cannulated Screw. As the trailing threads engage the bone, reduction is achieved. These trailing threads should be seated approximately 1mm below the cortex of the bone to ensure that there is no intra-articular protrusion or interference with the joint
function.

Different Types of Screws including 3.5 mm Herbert Screw

Cancellous Screws

Cannulated Screws

  • 2.5 mm Headless Compression Screws Partially Thread
  • 3 mm Headless Compression Screws Partially Thread
  • 3.5 mm Headless Compression Screws Partially Thread
  • 4 mm Headless Compression Screws Partially Thread
  • 4.5 mm Headless Compression Screws Partially Thread
  • 5.5 mm Headless Compression Screws Partially Thread
  • 6.5 mm Headless Compression Screws Partially Thread
  • 7.5 mm Headless Compression Screw Partially Thread
  • 5 mm Interference Screw
  • 6 mm Interference Screw
  • 7 mm Interference Screw
  • 8 mm Interference Screw
  • 9 mm Interference Screw
  • 10 mm Interference Screw

Bone screws are the most commonly used orthopedic implants. There are many different types and sizes of screws for different types of bones. Most bone screws are made out of stainless steel or titanium alloys. The outer diameter, root diameter, and thread pitch and angle are important in determining screw mechanics.

In orthopedics, screws are typically described by their outer diameter, for example, a “3.5 mm Herbert Screw” has an outside diameter of 3.5 mm. The pitch of a screw is the linear distance travelled by a screw for one full turn of the screw. The screw advances by a distance equal to the distance between the threads with each full turn. Cortical screws have a lower pitch and therefore more number of threads. Cancellous bone screws have a greater depth of the screw to increase the surface area and therefore improve the purchase, as the bone is weaker.

Screws function by converting the tightening torque into internal tension in the screw and elastic reactions in the surrounding bone. This creates compression between the fracture fragments that the screw is holding together. Screw is typically inserted into holes drilled equal to the root diameter and are either self-tapping or are inserted tapped (threaded) holes. The torque to insert cortical bone screws can be high, so the screws must be properly inserted into the correct size drilled hole and designed to withstand insertion torque levels expected in cortical bone. Cancellous bone screws have large, deep threads that grip the spongy bone well. Because of the relatively low strength of the cancellous bone, failure of the screw itself during insertion is rare, but pull out can be an issue.

3.5 mm Herbert Screw Contraindications

Contraindications may be qualified or total, and need to be taken into consideration when evaluating the prognosis in each case. The physician’s education, training and professional judgement must be relied upon to choose the most appropriate device and treatment. Conditions presenting an increased risk of failure include:

  • Any active or suspected latent infection or marked local inflammation in or about the affected area.
  • Compromised vascularity that would inhibit adequate blood supply to the fracture or the operative site.
  • Bone stock compromised by disease, infection or prior implantation that can not provide adequate support and/or fixation of the devices.
  • Material sensitivity, documented or suspected.
  • Obesity. An overweight or obese patient can produce loads on the implant that can lead to failure of the fixation of the device or to
    failure of the device itself.
  • Patients having inadequate tissue coverage over the operative site.
  • Implant utilization that would interfere with anatomical structures or physiological performance.
  • Any mental or neuromuscular disorder which would create an unacceptable risk of fixation failure or complications in postoperative care.
  • Other medical or surgical conditions which would preclude the potential benefit of surgery.
  • All associated diseases which could endanger the function and success of the 3.5 mm Herbert Screw.

Warnings and Precautionary for 3.5 mm Herbert Screw

Before using 3.5 mm Herbert Screw, the surgeon and ancillary staff should study the safety information in these instructions, as well as any product-specific information in the product description, surgical procedures and/or brochures.

Screws are made from medical grade materials and are designed, constructed and produced with utmost care. These quality screw assure best working results provided they are used in the proper manner. Therefore, the following instructions for use and safety recommendations must be observed.

Improper use of  screw can lead to damage to the tissue, premature wear, destruction of the instruments and injury to the operator, patients or other persons.

It is vital for the operating surgeon to take an active role in the medical management of their patients. The surgeon should thoroughly understand all aspects of the surgical procedure and instruments including their limitations. Care in appropriate selection and proper use of surgical instruments is the responsibility of the surgeon and the surgical team. Adequate surgical training should be completed before use of implants.

Factors which could impair the success of the operation:

  • Allergies to implanted materials.
  • Localized bone tumours.
  • Osteoporosis or osteomalacia.
  • System disease and metabolic disturbances.
  • Alcohol and drug abuse.
  • Physical activities involving excessive shocks, whereby the implant is exposed to blows and/or excessive loading.
  • Patients who are mentally unable to understand and comply with the doctor’s instructions.
  • Poor general health.

Possible Adverse Effects

The following adverse effects are the most common resulting from implantation:

  • Loosening of the screw, which may result from cyclic loading of the fixation site and/or tissue reaction of the implant.
  • Early and late infection.
  • Further bone fracture resulting from unusual stress or weakened bone substance.
  • Temporary or chronic neural damage resulting from pressure or hematomata.
  • Wound hematomas and delayed wound healing.
  • Vascular disease including venal thrombosis, pulmonary embolism and cardiac arrest.
  • Heterotopic ossification.
  • Pain and discomfort due to presence of the 3.5 mm Herbert Screw.
  • Mechanical failure of the implant, including bending, loosening or breakage.
  • Migration of implant resulting in injury.

Preoperative Planning for 3.5 mm Herbert Screw

The operating planning is carried out following a thorough clinical evaluation of the patient, Also, x-rays must be taken to allow a clear indication of the bony anatomy and associated deformities. At the time of the operation, the corresponding implantation instruments in addition to a complete size of 3.5 mm Herbert Screw must be available.

The clinician should discuss with the patient the possible risks and complications associated with the use of implants. It is important to determine pre-operatively whether the patient is allergic to any of the implant materials. Also, the patient needs to be informed that the performance of the device cannot be guaranteed as complications can affect the life expectancy of the device.

3.5 mm Herbert Screw Precautions

  • Confirm functionality of instruments and check for wear during reprocessing. Replace worn or damaged instruments prior to use.
  • It is recommended to use the instruments identified for this screw.
  • Handle devices with care and dispose worn bone cutting instruments in a sharps container.
  • Always irrigate and apply suction for removal of debris potentially generated during implantation or removal.

3.5 mm Herbert Screw Warnings

  • 3.5 mm Herbert Screw can break during use (when subjected to excessive forces). While the surgeon must make the final decision on removal of the broken part based on associated risk in doing so, we recommend that whenever possible and practical for the individual patient, the broken part should be removed. Be aware that implants are not as strong as native bone. Implants subjected to substantial loads may fail.
  • Instruments, screws and cut plates may have sharp edges or moving joints that may pinch or tear user’s glove or skin.
  • Take care to remove all fragments that are not fixated during the surgery.
  • While the surgeon must make the final decision on implant removal, we recommend that whenever possible and practical for the individual patient, fixation devices should be removed once their service as an aid to healing is accomplished. Implant removal should be followed by adequate post-operative management to avoid refracture.

3.5 mm Herbert Screw General Adverse Events

As with all major surgical procedures, risks, side effects and adverse events can occur. While many possible reactions may occur, some of the most common include: Problems resulting from anesthesia and patient positioning (e.g. nausea, vomiting, dental injuries, neurological impairments, etc.), thrombosis, embolism, infection, nerve and/or tooth root damage or injury of other critical structures including blood vessels, excessive bleeding, damage to soft tissues incl. swelling, abnormal scar formation, functional impairment of the musculoskeletal system, pain, discomfort or abnormal sensation due to the presence of the device, allergy or hypersensitivity reactions, side effects associated with hardware prominence, loosening, bending, or breakage of the device, mal-union, non-union or delayed union which may lead to breakage of the implant, reoperation.