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Nonunion of the Carpal NavicularModes of Treatment
Bruce Sprague, MD;
E. Jeff Justis, Jr., MD
AMA Arch Surg. 1974;108(5):692-697.
Abstract
The indications and methods of treatment for nonunion of the carpal navicular remain varied and controversial. Ninety-eight patients were seen because of symptoms due to a persistent nonunion. Of these, only 27 were sufficiently disabled to require reconstructive surgery: 13 with nonunion of waist fractures and mild radiocarpal degenerative changes underwent bone grafting and radial styloidectomy (ten had good results); seven with nonunion of the proximal third fractures and minimal degenerative changes were treated by bone grafting or excision of the fragment (depending on vascular status) and radial styloidectomy (four had good results, one poor); three with stable fibrous unions but having symptoms due to generative changes were successfully relieved by radial styloidectomy, and four patients required wrist fusion because of severe degenerative changes and pain.
Author Affiliations
Memphis
From the University of Iowa, Iowa City (Dr. Sprague), and the Campbell Clinic, Memphis (Dr. Justis).
Footnotes
Accepted for publication Oct 30, 1973.
Reprint requests to Department of Orthopedic Surgery, University of Iowa Hospitals and Clinics, University of Iowa, Iowa City 52242 (Dr. Sprague).
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