The navicular bone is an important part of the wrist joint, surrounded by the radius and the wrist bone to form the joint surface, 80% is covered by cartilage, the nutrient vessels enter from the lumbar and nodal parts, the direction of blood flow is distributed from far to near, the lumbar fracture can interrupt the blood flow of the proximal segment of the bone, thus easily causing ischemic necrosis of the navicular bone. I. According to the length of time of fracture occurrence, it is divided into fresh fracture and old fracture, so that different treatments can be adopted. 1.Fresh fracture: The traditional concept is that fresh navicular fracture without displacement is generally treated conservatively, and many hospitals adopt the treatment method of fixing the forearm plaster tube-type in a functional position, (the plaster should range from below the elbow to the distal transverse palmar line, and the thumb including the proximal phalanges), which we think is still inappropriate, because the simple forearm plaster cannot prevent the rotational function of the forearm, and when the forearm rotates The carpal ligaments will pull the navicular bone, which will affect the healing of the fracture and cause displacement of the fracture segment and necrosis. Therefore, a full upper limb cast fixation method should be adopted, i.e., from the elbow to the palm of the hand. During the fixation period, functional exercises for the fingers should be insisted on to avoid joint ankylosis. For nodal fractures, fixation should be done for 4-6 weeks, and for lumbar or proximal fractures for 3-4 months, sometimes even 6 months or a year. X-rays should be taken every 2 months or so during fixation to understand the healing of the fracture once poor healing or displacement of the fracture is detected. Patients with clinically suspected fractures and negative X-rays should be fixed in a cast first and then continue to be fixed after 2 weeks of removal of the cast and review of the photographs to confirm the fracture. Meanwhile, during the follow-up, when signs of fracture healing are found, the fixation of the cast should be changed in due course, changing the full upper limb cast to a forearm cast and starting to exercise the elbow joint. The long duration of plaster fixation of navicular fracture brings unimaginable inconvenience to patients’ life and work. Therefore, in recent years, foreign studies and clinical follow-ups have confirmed that early surgical internal fixation is the more ideal treatment. 2, old fracture: asymptomatic or mild symptoms can be left untreated, only reduce the amount of wrist activity, and continue to follow up and observe. For those with obvious symptoms, if no ischemic necrosis or bone disjunction is found, plaster fixation can also be tried, and it often takes 6-12 months to achieve bone healing, but there are many complications. If bone disjunction or ischemic necrosis has occurred, radial fascial bone flap transplantation, drilling bone grafting, proximal bone block resection or radial stem resection can be used according to the specific situation, and wrist joint fusion can be done if there is severe traumatic arthritis in the wrist joint. No matter what kind of surgery, it is a compensatory surgery, which is more traumatic and the later functional recovery is not ideal. According to the location of fracture, navicular fracture is divided into middle navicular fracture, proximal fracture and nodal fracture. If the fracture line of the navicular fracture is not obviously misaligned, the following signs should be noted to suggest the diagnosis: 1. fracture of the bony cortex of the navicular tuberosity; 2. small free fracture fragments in the navicular tuberosity or the head-boat joint space; 3. interruption of the bony cortex of one or both sides of the navicular joint surface or small fissures, folds and step-like changes perpendicular to the joint surface. Clinical manifestations Post-injury swelling and pain on the radial side of the wrist, with increased pain and limitation of wrist joint movement. There is obvious pressure pain at the nasopharyngeal fossa and navicular tuberosity. The wrist joint is radially deviated, and pain at the fracture site is caused by percussion or compression along the long axis of the Ⅰ and Ⅱ metacarpals. X-rays need to be taken in three directions: frontal, lateral and navicular positions of the wrist joint, which can mostly show the fracture line. Sometimes early X-rays are negative for fractures that are not displaced. In suspicious cases, the photos should be reviewed after two weeks, as the fracture line widens and becomes visible due to bone resorption at the fracture site after the injury. In old fractures, a significant widening of the fracture line and sclerosis or cystic changes at the fracture end are seen, which is a sign of bone disjunction, and ischemic necrosis if the proximal bone mass has increased in density and deformation, etc. Treatment recommendations Any patient with a history of wrist trauma, especially a fall with the palm of the hand propped up on the ground, should be seen early. For early periosteal fractures without significant displacement a conservative treatment of plaster fixation can be tried, but a strict follow-up should be done to observe the healing of the fracture. For patients with obvious displacement, surgical treatment with incision and internal fixation is recommended at an early stage, which can significantly reduce postoperative complications and bring great convenience to patients and enable them to resume normal work early with fast recovery and short plaster fixation time.