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Journal of Bone and Joint Surgery, 1941;23:841-850.
© 1941 by The Journal of Bone and Joint Surgery, Inc

THE CONSERVATIVE AND OPERATIVE TREATMENT OF FRACTURES OF THE CARPAL SCAPHOID (NAVICULAR)

RALPH SOTO-HALL M.D.1 and KEENE O. HALDEMAN M.D.1

1 Department of Surgery, Division of Orthopaedic Surgery, University of California Medical School, San Francisco

1. Success in the treatment of fractures of the carpal navicular depends upon the recognition of the fracture within two or three weeks of injury, and upon adequate and prolonged immobilization. Under these favorable conditions osseous union may be anticipated in a very high percentage of cases.

2. Excision of one or both fragments of the navicular is reserved for a limited number of cases, including those showing marked comminution and those in which other measures have failed.

3. From further experience in the operative treatment of non-union, it would seem that the drilling operation has a limited value; and that a procedure is indicated which combines the excision of the interposed fibrous tissue, the drilling of the bone, and the insertion of a bone graft from the radius. This procedure materially reduces the period of necessary immobilization and increases the chances of union.


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