In the period from 1986 through 1991 121 patients with injuries of the os naviculare pedis were treated at the Graz Hospital for Accident Surgery. The paper describes our experiences with the diagnosis and surgical management of such lesions. Only 7% of all fractures received surgical treatment. In the overwhelming majority of these cases drill wire osteosynthesis with subsequent plaster cast immobilization proved to be the method of choice, splintered fractures with a tendency to shortening of the limb had to be treated by spongiosa osteoplasty. Follow-up examinations (on average 42.6 weeks after primary management) using the score according to Gainor et al. showed very good and good results in 7 cases and only one negative result. Rotational X-ray examination is indispensable for establishing the diagnosis. Whenever possible, the exact extent of the injury should also be determined by CT.