Navicular fractures of the wrist are the most common wrist fracture, with an incidence of about 2% of all fractures in the body [1]. There are many clinical treatments including external fixation with plaster rests and internal fixation with incision and repositioning. If not properly diagnosed and treated, it can result in complications such as bone non-union, osteonecrosis, and traumatic osteoarthrosis. From May 2005 to March 2011, 24 cases of nondisplaced carpal navicular fractures were treated with percutaneous hollow nail internal fixation, and the fractures healed well with satisfactory results. 1. Data and methods 1.1 General data The 24 cases in this group, 21 males and 3 females, aged 18-52 years old, average 26.5 years old. There were 8 cases of left hand and 16 cases of right hand. The fractures were classified according to Krimmer typing [2], 2 cases of A1 type, 8 cases of A2 type, 5 cases of B1 type, and 9 cases of B3 type, all of which were closed injuries. There were 16 cases of fall injury, 3 cases of sports injury, 3 cases of car accident, and 2 cases of crush injury. All the cases in this group were undisplaced navicular fractures, and the average time from injury to surgery was 3 d-28 d. All the cases in this group were routinely examined by navicular and lateral X-ray of the wrist joint and CT examination of the wrist joint before surgery. 1.2 Surgical method The patient was placed in a flat position, anesthetized by brachial plexus block, and the bony mark of the navicular tuberosity was palpated on the palmar side of the wrist before surgery, with the palm facing upward and an axial roll on the dorsal side of the wrist, so that the wrist joint was dorsally extended about 30°-45°. The radial and distal ends of the navicular tuberosity are selected as the guide needle entry points, and the 1 mm guide needle is drilled along the long axis of the navicular bone as far as possible so that the direction of the guide needle entry is perpendicular to the fracture line and penetrates the proximal bone, generally at an angle of 45° to the palmar side of the forearm and parallel to the axis of the first metacarpal bone. During the drilling process, the direction can be adjusted according to the C-arm fluoroscopy. After penetrating the needle, the navicular and lateral positions of the wrist joint are viewed fluoroscopically, and the depth of the guide needle to 1 mm of the proximal articular surface cortex of the navicular bone is preferred. Measure the length of the guide needle into the navicular bone minus 2mm for the length of the hollow nail, make a 3mm skin incision around the skin entry point of the guide needle, drill a hole with a hollow drill, drill 3-5mm, no tapping is required, remove part of the bone cortex at the entry point with a buried head device, select the appropriate length of hollow nail screwed along the guide needle, pull out the guide needle, C-arm fluoroscopy of the navicular and lateral position of the wrist joint, after satisfactory fixation, the incision is closed with a stitch, no plaster After satisfactory fixation, the incision was closed with one stitch, and functional exercises of the fingers and wrist joint were started after surgery without the need for a cast. All 24 fractures healed without infection, bone discontinuity or screw loosening. 23 cases had a range of wrist motion from 125° to 145°, including one case with a wrist motion of 128° and mild pain during wrist motion. Wrist function was scored according to Krimmer score [3]: excellent 22 cases, good 1 case, satisfactory 1 case, no screws were removed in all cases, including 1 case with decreased skin sensation at the greater piriformis. The DASH questionnaire was used as the subjective functional evaluation of the patients. It was divided into two parts, A and B. The 23 questions in part A were mainly to understand the patients’ ability to engage in daily activities; the 77 questions in part B were mainly to investigate the patients’ upper limb discomfort symptoms, and each question was divided into 5 levels, with a DASH value of 0 indicating normal function and a score of 100 indicating no function. The average DASH questionnaire value of this group was 7.5 points. 95% of the activities in part A of the DASH table were basically normal, with only slight activity limitation when carrying heavy objects and supporting the wrist, while in part B of the DASH table, some patients had slight pain when bearing weight, and other discomforts included pain at rest, weakness, and joint stiffness. 3. Discussion Carpal navicular fracture is the most common type of wrist fracture, mostly in young people, and is classified by site: nodal, lumbar, and proximal 1/3 fractures, with lumbar fractures being the most common. According to the fracture displacement, it is divided into stable and unstable type. The non-union rate of navicular fractures is high, especially lumbar fractures and proximal 1/3 fractures. The aim of treatment for navicular fracture is to make the fracture heal as soon as possible, restore the normal function of the wrist joint and recover early. For stable fractures without displacement, there is no significant difference in the long-term efficacy between conservative treatment and surgical treatment. Many physicians still adhere to the traditional treatment method [6]. For displaced stable navicular fractures, they are treated by external fixation with a tubular plaster rest for 12 weeks or even longer. The prolonged external fixation prevents early and effective functional exercise of the wrist joint, which can lead to joint stiffness, muscle atrophy, and osteoporosis. The joint cannot be restored to the normal state, and during the fixation of the cast, it is easy to loosen, and the stability is poor, causing displacement of the fracture end, thus affecting the fracture healing; if the cast is too tight, it will cause pressure on the skin, and skin necrosis will occur. If the cast is too tight, the skin will be compressed and skin necrosis will occur. The internal fixation with incision and restoration of the Kirschner pin is not strong enough and the stability is poor, which cannot form pressure on the fracture break and affect the healing of the fracture end, thus causing non-union or delayed healing of the fracture, and the internal fixation with the Kirschner pin has to be assisted by a plaster rest brake, so that the wrist joint cannot perform early and effective functional exercise, thus affecting the functional recovery of the wrist joint. The incision of the navicular fracture is large and the joint capsule is cut, which destroys the blood flow of the navicular bone and is not conducive to the repair of soft tissues, with great trauma, many complications and long hospital stay. The advantages of percutaneous hollow nail internal fixation for nondisplaced carpal navicular fracture: small incision, little trauma, no destruction of blood supply, and a minimally invasive procedure. The fixation is firm and strong, forming pressure on the fracture end, which is conducive to fracture healing. It does not require external fixation with a plaster brace after surgery, and can be used for early functional exercise and good functional recovery of the wrist joint. The patient has less pain and shorter hospital stay, and can return to work as soon as possible. In conclusion, the treatment of nondisplaced carpal navicular fracture by percutaneous hollow nailing is simple, less traumatic, firmly fixed, with high fracture healing rate and definite efficacy. Early functional exercise and good recovery of joint function can be achieved, which is an effective treatment method and is worth promoting.