The disease is characterized by the fact that not all patients go to the doctor with serious complaints. Some people continue to exercise without noticing for a long time that there are problems with their joints.
Clinical manifestations of pseudoarthrosis of the navicular bone may or may not be accompanied by the presence of arthrotic changes in the joint, and bone fragments may be viable, sclerotic (in this case, there is no pain) or already susceptible to necrosis. If the fragments are necrotic, they must be removed; if the fragments remain viable, removal can also be performed if the patient comes with serious complaints.
The two most common methods of treating pseudoarthrosis of the navicular bone are styloidectomy and osteoplasty. During styloidectomy, the styloid process of the radius is removed, pressing on the navicular bone. Styloidectomy is important not so much for the fusion of pseudoarthritis as for creating convenient conditions for osteoplasty.
Osteoplasty can only be performed if the fragments are viable and there are no arthrotic changes in the joint. During the operation, the main thing is to maintain the stability of the fragments that was present at the initial moment. To close the cavity formed after curettage of spongy tissue, a graft is used, which is taken/removed from the metaphysis of the radius. After surgery, it is necessary to immobilize the limb for a long time; a plaster cast is applied according to the same principle as for fresh fractures.
As a rule, specialists are wary of removing the navicular bone and installing an endoprosthesis in its place, since there is a high probability of an unfavorable outcome: the proximal metacarpal canal is quite sensitive to foreign bodies.
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