The Common Vein Copyright 2011
Definition
Fractures of the pisiform are usually caused by direct trauma as a result of a fall onto the palm of the hand .
Pisiform fractures are rare and usually occur with fractures of the distal radius, hamate, or triquetrum.
The fracture may be complicated in the acute phase by neurovascular injury, or in the subacute or chronic phases by nonunion, malunion, infection, osteonecrosis, or osteoarthritis.
The diagnosis of this injury is usually made by a combination of physical examination and x-ray imaging.
Imaging includes the use of plain x-rays, and if indicated CT-scan, or MRI.
Treatment depends on the specific type of fracture and how acutely sick the patient is.
Nondisplaced fractures are treated with a short arm cast or ulnar gutter splint for 6 weeks. Displaced fractures are treated with surgical excision.
The Normal Pisiform |
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The externally rotated A-P view of both hands is normal and enables the exposure of the often hidden pisiform bone (white arrow) Courtesy Ashley Davidoff MD 45754b01 |
References
Davis MF, Davis PF, Ross DS. Expert Guide to Sports Medicine. ACP Series, 2005.
Elstrom J, Virkus W, Pankovich (eds), Handbook of Fractures (3rd edition), McGraw Hill, New York, NY, 2006.
Koval K, Zuckerman J (eds), Handbook of Fractures (3rd edition), Lippincott Williams & Wilkins, Philadelphia, PA, 2006.
Lieberman J (ed), AAOS Comprehensive Orthopaedic Review, American Academy of Orthopaedic Surgeons, 2008.
Moore K, Dalley A (eds), Clinically Oriented Anatomy (5th edition), Lippincott Williams & Wilkins, Philadelphia, PA, 2006.