Treatment of Ununited Fractures and Pseudoarthroses of Navicular Bone

Abstract

The treatment results of 256 patients with ununited fractures and pseudoarthroses of navicular bone are presented. In 107 patients (41,8%) diagnostic mistakes were made at early stages and in 84 patients (32,8%) treatment mistakes were detected. In 65 patients (41.4%) navicular bone fractures were not diagnosed at timely radiologic examination. Two hundred four patients (79.6%) were treated with distraction device elaborated at the clinic. In ununited fractures the rate of distraction was 1 mm/day up to 6-8 mm distraction wrist joint and then fixation in device during 4 weeks was used. After the removal of the device plaster cast was applied. In pseudoarthroses the distraction rate was 1 mm/day up to 1 cm distraction of the joint with subsequent fixation for 6-8 weeks. In navicular bone fractures with displacement fragments the reduction of fragments took place in most of the cases. When reduction was not achieved the open reduction of fragments was performed after joint distraction. Good and satisfactory results were achieved in 90.2% of cases.