We need you! See something you could improve? Make an edit and help improve WikSM for everyone.

Pisiform Fracture

From WikiSM
Jump to: navigation, search


Other Names

  • N/A

Background

  • Pisiform fractures account for approximately 2% of carpal bone fractures[1]

Pathophysiology


Risk Factors

  • Unknown

Differential Diagnosis

Carpal Bone Fractures

Differential Diagnosis Wrist Pain


Clinical Features


Evaluation

Radiographs

  • Standard Radiographs Wrist
  • 3 view initially
  • Not very sensitive
  • May require 30° supinated view, 45° supinated oblique or carpal tunnel view

CT

  • Better evaluate fracture pattern, management plan

MRI

  • High index of suspicion despite negative radiographs

Classification

  • Transverse
  • Parasagittal
  • Comminuted
  • Pisiform-triquetral impaction fractures

Management

Nonoperative

  • In general, fracture pattern does not dictate management
  • Encouraged to consult hand surgery for definitive decision making
  • Potential Indications
    • Parasagittal
    • Non-displaced transverse intra-articular fractures
  • Cast: Short Arm Cast in wrist flexion and ulnar deviation for 6-8 weeks

Operative

  • Indications
    • Displaced
    • FCU Dysfunction
    • Comminuted
  • Procedures
    • Pisiform excision

Return to Play

  • At discretion of surgeon
  • Minimum 6 weeks

Complications

  • Chronic pain
  • Non-union
  • Pisotriquetral arthritis
  • Malunion
  • Decreased grip strength

See Also


References

  1. Suh, Nina, Eugene T. Ek, and Scott W. Wolfe. "Carpal fractures." The Journal of hand surgery 39.4 (2014): 785-791.
Created by:
John Kiel on 18 June 2019 22:56:36
Authors:
Last edited:
13 October 2022 21:42:27
Categories:
Trauma | Osteology | Wrist | Upper Extremity | Fractures | Acute