Internal fixation for fracture of the carpal navicular bone is surgically feasible, but requires an exacting technique for the prevention of complications potentially more serious than non-union. The relative merits of nails1 or screws as fixation devices remain to be established. The small experience reported here warrants no conclusions, but suggests the following:
1. With perfection of operative technique, internal fixation may become the treatment of choice for displaced and unstable fractures of the carpal navicular.
2. The prognosis for any fracture of the carpal navicular may depend as much upon the intrinsic stability of the fragments as upon the level of the fracture, or the vascular status of the proximal fragment.
3. The morbidity of fractures of the carpal navicular is reduced greatly by internal fixation.
4. Rapid relief of symptoms and return of function follow stabilization of an ununited navicular fracture by internal fixation, but bone healing is not to be expected following this procedure alone.
Department of Orthopaedic Surgery, College of Physicians and Surgeons, Columbia University, and the Fracture Service, Presbyterian-New York Orthopaedic Hospitals, New York City