Primary internal fixation of carpal navicular fractures in the athlete

Abstract

Primary open reduction and internal fixation is an established procedure for treatment of carpal navicular fractures. With the use of an alignment device, the surgery can be performed on outpatients, under local anesthesia, in 30 to 45 min. The wrist is splinted in a protective device for approximately 6 weeks but no cast is necessary. Four of 13 patients in this series have been athletes. The procedure has allowed them to participate in sports during the healing period and to return to contact sports 6 to 8 weeks postoperatively without joint protection. These athletes have regained full range of motion in the wrist joint. Although the procedure is not recommended for hairline fractures which usually heal quickly or comminuted fractures of the navicular, it appears to be the treatment of choice for fractures of the carpal navicular bone at the level of the middle and proximal third of the bone or any displaced fragment with malposition in the axial or rotary plane.