Dr. Turner: An 18-year-old girl fell while playing football. She attempted to break the fall with her outstretched right hand and experienced severe pain in the right wrist. She was seen at the Massachusetts General Hospital one hour following injury.
Results of a physical examination were completely normal except for the right wrist. There was pain, swelling, and deformity of the wrist with dorsal displacement of the hand and distal carpal bones in relation to the distal radius. Circulation and sensation were completely intact.
X-ray films showed a transverse fracture through the mid portion of the navicular, with dorsal dislocation of the distal navicular fragment and the entire distal carpal row. The lunate remained in its normal relationship with the distal radius. (Fig 1).
Dr. Aufranc: Dr. Edward A. Nalebuff, of our Massachusetts General Hospital staff, has been very interested in hand and wrist injuries, and will discuss the mechanism