We used the Richards scaphoid compression staple for operative fixation
in a total of twenty-five patients who had a fracture of the carpal
scaphoid: sixteen whom we reported on previously and nine whom we are
reporting on for the first time here. In the current series, we extended
the application of the method to fresh, unstable fractures (two patients)
and treated an additional seven patients who had a non-union or delayed
union. The procedure was simple, and no operative complications were
encountered. Both patients who had a fresh fracture had a satisfactory
result. Of the other twenty-three patients, only two had a result that was
not satisfactory. One patient had a persistent non-union. Three patients
had doubtful radiographic evidence of a persistent non-union; however, all
three had a good result clinically, and only one had moderate loss of
function. Although the over-all results were good, there was some worsening
of the clinical results on long-term follow-up compared with those that we
reported earlier. This deterioration probably was due to secondary
degenerative changes in the articular surfaces.