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September 29, 1945


JAMA. 1945;129(5):335-338. doi:10.1001/jama.1945.02860390021006

Fractures of the carpal scaphoid offer a great challenge to the surgeon, for on his skill in diagnosis and treatment rests the ultimate functional result. The treatment of recent fractures of this type is almost a solved problem, as shown by the many studies of end results in the last few years. But too many surgeons fail, either because they are not vigilant in noting and following the most minute details in diagnosis and treatment, or because they experiment with methods which are not founded on sound anatomic principles.

DIAGNOSIS  This fracture must be diagnosed immediately after the injury, and failure to do so is one of the main causes of nonunion. A note of warning must be given about diagnosis of so-called severe sprain of the wrist, too often made because of negative roentgenograms, and it is a good working rule to deny its existence. Injuries to the semilunar